AIM: We investigated the literature of randomised placebo-controlled trials to find out if transcutaneous electrical nerve stimulation (TENS) or acupuncture-like transcutaneous electrical nerve stimulation (ALTENS) can reduce analgesic consumption after surgery. RESULTS: Subgroup analysis for adequate treatment (pulse frequency: 1-8Hz [ALTENS] or 25-150Hz [TENS], current intensity: "strong, definite, subnoxious, maximal tolerable" or above 15mA, and electrode placement in the incision area) were performed. Twenty-one randomised, placebo-controlled trials with a total of 1350 patients were identified. For all trials, the mean reduction in analgesic consumption after TENS/ALTENS was 26.5% (range -6 to +51%) better than placebo. Eleven of the trials compromising 964 patients, had reports which stated that a strong, subnoxious electrical stimulation with adequate frequency was administered. They reported a mean weighted reduction in analgesic consumption of 35.5% (range 14-51%) better than placebo. In nine trials without explicit confirmation of sufficient current intensity and adequate frequency, the mean weighted analgesic consumption was 4.1% (range -10 to +29%) in favour of active treatment. The difference in analgesic consumption was significantly (p=0.0002) in favour of adequate stimulation. The median frequencies used in trials with optimal treatment was 85Hz for TENS and 2Hz in the only trial that investigated ALTENS. CONCLUSION: TENS, administered with a strong, subnoxious intensity at an adequate frequency in the wound area, can significantly reduce analgesic consumption for postoperative pain.
AIM: We investigated the literature of randomised placebo-controlled trials to find out if transcutaneous electrical nerve stimulation (TENS) or acupuncture-like transcutaneous electrical nerve stimulation (ALTENS) can reduce analgesic consumption after surgery. RESULTS: Subgroup analysis for adequate treatment (pulse frequency: 1-8Hz [ALTENS] or 25-150Hz [TENS], current intensity: "strong, definite, subnoxious, maximal tolerable" or above 15mA, and electrode placement in the incision area) were performed. Twenty-one randomised, placebo-controlled trials with a total of 1350 patients were identified. For all trials, the mean reduction in analgesic consumption after TENS/ALTENS was 26.5% (range -6 to +51%) better than placebo. Eleven of the trials compromising 964 patients, had reports which stated that a strong, subnoxious electrical stimulation with adequate frequency was administered. They reported a mean weighted reduction in analgesic consumption of 35.5% (range 14-51%) better than placebo. In nine trials without explicit confirmation of sufficient current intensity and adequate frequency, the mean weighted analgesic consumption was 4.1% (range -10 to +29%) in favour of active treatment. The difference in analgesic consumption was significantly (p=0.0002) in favour of adequate stimulation. The median frequencies used in trials with optimal treatment was 85Hz for TENS and 2Hz in the only trial that investigated ALTENS. CONCLUSION: TENS, administered with a strong, subnoxious intensity at an adequate frequency in the wound area, can significantly reduce analgesic consumption for postoperative pain.
Authors: Marie K Hoeger Bement; Barbara J St Marie; Terry M Nordstrom; Nicole Christensen; Jennifer M Mongoven; Ian J Koebner; Scott M Fishman; Kathleen A Sluka Journal: Phys Ther Date: 2013-12-05
Authors: Barbara Rakel; Nicholas Cooper; Heather J Adams; Bryan R Messer; Laura A Frey Law; Douglas R Dannen; Carrie A Miller; Anya C Polehna; Rachelle C Ruggle; Carol G T Vance; Deirdre M Walsh; Kathleen A Sluka Journal: J Pain Date: 2009-11-27 Impact factor: 5.820
Authors: Linda S Chesterton; Daniëlle A van der Windt; Julius Sim; Martyn Lewis; Christian D Mallen; Elizabeth E Mason; Catherine Warlow; Kanchan Vohora; Elaine M Hay Journal: BMC Musculoskelet Disord Date: 2009-12-11 Impact factor: 2.362