Effect of Transcutaneous Electrical Nerve Stimulation on the Pain Intensity During Insertion of Needle in Patients Undergoing Spinal Anesthesia: A Randomized Controlled Study

Background. Traditionally, laparoscopic procedures have been performed under general anesthesia. Spinal anesthesia is an effective alternative to general anesthesia. However, one of the intraoperative complications of performing laparoscopic surgery under spinal anesthesia is shoulder pain. This study aimed to compare the effect of transcutaneous electrical nerve stimulation (TENS) with fentanyl on pain relief in patients who underwent gynecologic laparoscopy under spinal anesthesia. Methods. We conducted a prospective randomized clinical trial from May 2016 to March 2017. A sample of patients who underwent gynecological laparoscopy under spinal anesthesia was recruited. If they had shoulder pain, they randomly received either transcutaneous electrical nerve stimulation (TENS) or 50 mg of fentanyl. Pain intensity was measured using the single item visual analogue scale (VAS-10 cm) immediately before and 5, 10, 20, and 30 minutes after treatment. Also, the effect of higher doses of analgesia on pain relief was analyzed. Results. In all, 80 patients (40 patients in each group) were entered into the study. The mean pain intensity score was 9.02 ± 1.32 in the TENS group and 8.95 ± 1.33 in the fentanyl group at baseline (P = 0.80). Repeated measures analysis of variance indicated that there was no significant difference on overall pain scores between the two treatment groups adjusted for age, BMI, total analgesia used, and baseline pain score (F (1, 74) = 1.44, P = 0.23). The use of analgesic drugs in the TENS group was significantly higher than the fentanyl group (P = 0.01). In addition, we found that nine patients (22.5%) complained of nausea/vomiting in the TENS group compared to thirteen patients (32.5%) in the fentanyl group (P = 0.31). Conclusions. The findings indicated that TENS was not superior to fentanyl for pain relief in laparoscopic surgery. It seems that the correct use of TENS parameters might merit further investigation. This trial is registered with: IRCT2016031216765N3.

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Effectiveness of Heel-Raise-Lower Exercise after Transcutaneous Electrical Nerve Stimulation in Patients with Stroke: A Randomized Controlled Study

Journal of Clinical Medicine ◽

10.3390/jcm9113532 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3532

Author(s):

Kyoung-sim Jung ◽

Jin-hwa Jung ◽

Tae-sung In ◽

Hwi-young Cho

Keyword(s):

Placebo Group ◽

Muscle Strength ◽

Nerve Stimulation ◽

Gait Speed ◽

Transcutaneous Electrical Nerve Stimulation ◽

Controlled Study ◽

Walk Test ◽

Plantar Flexors ◽

Electrical Nerve Stimulation ◽

Randomized Controlled

Objective: This study was conducted to investigate the effect of the heel-raise-lower exercise on spasticity, strength, and gait speed after the application of 30 min of transcutaneous electrical nerve stimulation (TENS) in patients with stroke. Methods: The participants were randomly divided into the TENS group and the placebo group, with 20 participants assigned to each group. In the TENS group, heel-raise-lower exercise was performed after applying TENS for six weeks. The placebo group was trained in the same manner for the same amount of time but without electrical stimulation. The spasticity of the ankle plantar flexors was measured using the composite spasticity score. A handheld dynamometer and a 10-m walk test were used to evaluate muscle strength and gait speed, respectively. Results: Spasticity was significantly more improved in the TENS group (mean change −2.0 ± 1.1) than in the placebo group (mean change −0.4 ± 0.9) (p < 0.05). Similarly, muscle strength was significantly more improved in the TENS group (6.4 ± 3.3 kg) than in the placebo group (4.5 ± 1.6 kg) (p < 0.05). Moreover, participants assigned to the TENS group showed a significant greater improvement in gait speed than those in the placebo group (mean change −5.3 ± 1.4 s vs. −2.7 ± 1.2 s). Conclusions: These findings show the benefits of heel-raise-lower exercise after TENS for functional recovery in patients with stroke.

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