Transcutaneous electrical nerve stimulation (TENS) in the management of post-thoracotomy pain: A systematic review

Introduction: Thoracotomy is considered one of the most painful operative procedures in surgical practice, and postoperative pain control is a challenge. Objectives: To evaluate transcutaneous electrical nerve stimulation (TENS) as a form of treatment for post-thoracotomy pain. Design and setting: A systematic review conducted at the Pontifical Catholic University of Goiás. Methods: A systematic literature review was performed in the PubMed and Lilacs databases with the terms: “Post-thoracotomy pain AND (Transcutaneous Electric Nerve Stimulation OR TENS)”, being selected randomized controlled trials, clinical trials and case reports. Studies that did not fit the objectives were excluded. Results: TENS was shown to be a safe and effective therapy in the management of acute post-thoracotomy pain in the emergency department; however, the technique did not decrease the length of hospital stay or early pulmonary complications. One such study pointed to decreased shoulder flexion pain in patients undergoing axillary thoracotomy for lung resection, with pain sensation significantly decreased in the experimental group. In consonance, other trials emphasized the importance of the association of TENS with pharmacological therapy already employed in the emergency department, because patients who received fentanyl and bupivacaine associated with TENS perceived an immediate reduction in pain intensity at rest. Conclusion: TENS has proven to be a very effective and safe therapy in the treatment of postoperative pain in patients undergoing thoracotomy, improving their quality of life and reducing the consumption of analgesics.