Bundsen P, Carlsson C A, Forssman L, Tyreman N O
Prakt Anaesth. 1978 Feb;13(1):20-8.
The analgesic effect of transcutaneous electrical nerve stimulation (TNS) during delivery has been evaluated. The usual technique of TNS was modified to suit the specific needs of pain control during the whole course of delivery. Two pairs of electrodes were taped to the patient's back, one pair level with the spinal processes Th 10-L1 and the other with S2-S4, corresponding to the influx of pain during the first and second stages respectively. Stimulation was delivered as biphasic pulses at 60-80 Hz. A low-intensity stimulation was given continuously, and a high-intensity stimulation was initiated by the patient herself whenever pain increased. As a rule, stimulation via the thoracic electrodes was given throughout delivery and sacral stimulation added from the later part of the first stage. No complications with respect to mother or child have occured. Three hundred and forty-seven women have been treated, 47% of them considered the analgesia with TNS to be good or very good, 42% experienced a certain effect whil 11% considered that TNS made no difference. In view of the relatively good results and the absence of complications, the authors recommend the method as a primary pain relieving measure to which conventional methods can be added if necessary.
分娩期间经皮电神经刺激(TENS)的镇痛效果已得到评估。对TENS的常规技术进行了改进,以适应分娩全过程疼痛控制的特殊需求。将两对电极贴在患者背部,一对与胸10至腰1椎体棘突水平对齐,另一对与骶2至骶4水平对齐,分别对应第一产程和第二产程的疼痛传入部位。以60 - 80赫兹的双相脉冲进行刺激。持续给予低强度刺激,当疼痛加剧时由患者自己启动高强度刺激。通常,整个分娩过程中通过胸部电极进行刺激,从第一产程后期开始增加骶部刺激。未出现与母婴相关的并发症。已对347名女性进行治疗,其中47%的女性认为TENS镇痛效果良好或非常好,42%的女性有一定效果,11%的女性认为TENS没有效果。鉴于相对良好的结果以及无并发症,作者推荐该方法作为主要的疼痛缓解措施,必要时可加用传统方法。