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Effects of high-frequency, high-intensity transcutaneous electrical nerve stimulation versus intravenous opioids for pain relief after gynecologic laparoscopic surgery: a randomized controlled study

Artikel i vetenskaplig tidskrift
Författare B. Platon
Clas Mannheimer
Paulin Andréll
Publicerad i Korean Journal of Anesthesiology
Volym 71
Nummer/häfte 2
Sidor 149-156
ISSN 2005-6419
Publiceringsår 2018
Publicerad vid Institutionen för medicin, avdelningen för molekylär och klinisk medicin
Sidor 149-156
Språk en
Länkar doi.org/10.4097/kjae.2018.71.2.149
Ämnesord Gynecologic, Laparoscopy, Opioid, Pain, Transcutaneous electrical nerve stimulation, postoperative pain, controlled-trial, angina-pectoris, tens, analgesia, Anesthesiology, lsom i, 1994, american journal of obstetrics and gynecology, v170, p123
Ämneskategorier Anestesiologi

Sammanfattning

Background: The aim of the study was to compare the pain relieving effect and the time spent in the recovery unit after treatment with high frequency, high-intensity transcutaneous electrical nerve stimulation (TENS) or intravenous (IV) opioids after gynecologic laparoscopic surgery. Methods: All patients who postoperatively reported visual analogue scale (VAS) pain score >= 3 were consecutively included in the study. The TENS treatment was given with a stimulus intensity between 40-60 mA during 1 minute, repeated once if insufficient pain relief. In the opioid group, a maximum dose of 10 mg morphine was given IV. If the patient reported insufficient pain relief (VAS = 3) on the assigned treatment, the patient crossed over to the other treatment group. Results: Ninety-three women were randomized to TENS (n = 47) or IV opioids (n = 46). Both groups reported significant pain relief at leave from the recovery unit (TENS group: VAS 5.4 to 1.0, P < 0.001; IV opioid group: VAS 5.2 to 1.1, P < 0.001) with no differences between the groups. When only responders, i.e. patients with VAS < 3 after assigned treatment, were compared the TENS responders spent significantly shorter time in the recovery unit (90 vs. 122 minutes, P = 0.008) compared to the responders in the opioid group. Conclusions: TENS and IV opioids are both effective treatments for pain relief after gynecologic laparoscopic surgery. TENS seems to be preferable for first choice of treatment as the treatment is associated with shorter time spent in recovery unit if the patient responds to the treatment.

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