Siddharth A Mahure1, Andrew S Rokito2, Young W Kwon2. 1. New York University Hospital for Joint Diseases, New York, NY, USA. Electronic address: Siddharth.mahure@nyumc.org. 2. New York University Hospital for Joint Diseases, New York, NY, USA.
Abstract
BACKGROUND:Arthroscopic rotator cuff repair (ARCR) can be associated with significant postoperative pain. Concern for opioid abuse has led surgeons to identify alternative, efficacious methods of postoperative analgesia. To determine whether transcutaneous electrical nerve stimulation (TENS) can have a similarly beneficial effect after shoulder procedures, we conducted a prospective double-blinded randomized trial in patients undergoing outpatient ARCR. METHODS:All patients undergoing ARCR of a full-thickness rotator cuff tear by the senior authors were identified. Patients with a history of recent narcotic use or prior narcotic abuse and those under management of a pain control specialist were excluded. Patients were randomized into 2 groups, active or placebo TENS, and used the device for 4 sessions/day for 45 minutes/session for the first postoperative week. All patients received Percocet 5/325 mg (oxycodone/acetaminophen) for use as rescue pain pills. One-week narcotic consumption and visual analog scale pain scores were compared between groups. RESULTS: The final analysis included 37 patients (21 active,16 placebo). Baseline and procedural differences were not different between groups. At 1 week postoperatively, patients in the active group had significantly lower pain scores (3.6 ± 2.1 vs. 5.8 ± 1.2; P= .008). Postoperative Percocet consumption during the initial 48 hours (12.8 ± 4.7 vs. 17.2 ± 6.3; P = .020) and during the first week (25.2 ± 9.9 vs. 33.8 ± 14.3; P = .037) was also significantly lower in the active group. CONCLUSION: Results from this prospective double-blinded randomized trial demonstrate that compared with placebo TENS, active TENS can result in significantly less pain and reduced opioid use in the immediate postoperative period after ARCR, suggesting that TENS may be potentially useful in a multimodal approach to managing postoperative pain.
RCT Entities:
BACKGROUND: Arthroscopic rotator cuff repair (ARCR) can be associated with significant postoperative pain. Concern for opioid abuse has led surgeons to identify alternative, efficacious methods of postoperative analgesia. To determine whether transcutaneous electrical nerve stimulation (TENS) can have a similarly beneficial effect after shoulder procedures, we conducted a prospective double-blinded randomized trial in patients undergoing outpatient ARCR. METHODS: All patients undergoing ARCR of a full-thickness rotator cuff tear by the senior authors were identified. Patients with a history of recent narcotic use or prior narcotic abuse and those under management of a pain control specialist were excluded. Patients were randomized into 2 groups, active or placebo TENS, and used the device for 4 sessions/day for 45 minutes/session for the first postoperative week. All patients received Percocet 5/325 mg (oxycodone/acetaminophen) for use as rescue pain pills. One-week narcotic consumption and visual analog scale pain scores were compared between groups. RESULTS: The final analysis included 37 patients (21 active,16 placebo). Baseline and procedural differences were not different between groups. At 1 week postoperatively, patients in the active group had significantly lower pain scores (3.6 ± 2.1 vs. 5.8 ± 1.2; P= .008). Postoperative Percocet consumption during the initial 48 hours (12.8 ± 4.7 vs. 17.2 ± 6.3; P = .020) and during the first week (25.2 ± 9.9 vs. 33.8 ± 14.3; P = .037) was also significantly lower in the active group. CONCLUSION: Results from this prospective double-blinded randomized trial demonstrate that compared with placebo TENS, active TENS can result in significantly less pain and reduced opioid use in the immediate postoperative period after ARCR, suggesting that TENS may be potentially useful in a multimodal approach to managing postoperative pain.
Authors: Mark I Johnson; Carole A Paley; Priscilla G Wittkopf; Matthew R Mulvey; Gareth Jones Journal: Medicina (Kaunas) Date: 2022-06-14 Impact factor: 2.948
Authors: Jacob Gorbaty; Susan M Odum; Meghan K Wally; Rachel B Seymour; Nady Hamid; Joseph R Hsu; Michael Beuhler; Michael J Bosse; Michael Gibbs; Christopher Griggs; Steven Jarrett; Daniel Leas; Tamar Roomian; Michael Runyon; Animita Saha; Bradley Watling; Stephen Wyatt; Ziqing Yu Journal: Arthrosc Sports Med Rehabil Date: 2021-02-03
Authors: Vincenzo Candela; Umile Giuseppe Longo; Calogero Di Naro; Gabriella Facchinetti; Anna Marchetti; Gaia Sciotti; Giulia Santamaria; Ilaria Piergentili; Maria Grazia De Marinis; Ara Nazarian; Vincenzo Denaro Journal: Int J Environ Res Public Health Date: 2020-09-20 Impact factor: 3.390