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Erschienen in: Lung 2/2020

08.02.2020 | THORACIC SURGERY

Effects of Transcutaneous Electrical Nerve Stimulation on Pain, Pulmonary Function, and Respiratory Muscle Strength After Posterolateral Thoracotomy: A Randomized Controlled Trial

verfasst von: Hermann H. Husch, Guilherme Watte, Matheus Zanon, Gabriel Sartori Pacini, Daniella Birriel, Pauline L. Carvalho, Adriana Kessler, Graciele Sbruzzi

Erschienen in: Lung | Ausgabe 2/2020

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Abstract

Purpose

To evaluate the effects of transcutaneous electrical nerve stimulation (TENS) compared to placebo TENS and a control group on pain, pulmonary function, respiratory muscle strength, and analgesic medications in the postoperative period of thoracotomy in an Intensive care unit (ICU).

Methods

Patients who had undergone posterolateral thoracotomy were randomly allocated to receive TENS during ICU stay, or placebo TENS, or into the control group. All groups received conventional physiotherapy. We analysed the intensity of pain, pulmonary function, respiratory muscle strength, and use of analgesia medications. Outcomes were evaluated before surgery, immediately after, 24 and 48 h after ICU admission.

Results

Forty-five patients were included. Regarding pain perception, there was no difference between groups (p = 0.172), but there was a significant reduction in pain intensity for patients receiving TENS after first physiotherapy session compared to baseline (4.7 ± 3.2 vs 3.3 ± 2.6; p < 0.05). All groups had a decrease in forced vital capacity (FVC) after surgery (p < 0.001). There was no difference between the groups regarding the use of analgesic medications, but a higher intake of morphine and acetaminophen were observed for the control (p = 0.037) and placebo group (p = 0.035), respectively.

Conclusion

The use of TENS provides a little benefit of pain (in the first 12 h) but failed to demonstrate any improvement in the recovery of ICU patients after 48 h of posterolateral thoracotomy.

Trial Registration

NCT02438241.
Literatur
1.
Zurück zum Zitat Savage C, McQuitty C, Wang D, Zwischenberger JB (2002) Postthoracotomy pain management. Chest Surg Clin N Am 12(2):251–263CrossRef Savage C, McQuitty C, Wang D, Zwischenberger JB (2002) Postthoracotomy pain management. Chest Surg Clin N Am 12(2):251–263CrossRef
2.
Zurück zum Zitat Landreneau RJ, Pigula F, Luketich JD, Keenan RJ, Bartley S, Fetterman LS et al (1996) Acute and chronic morbidity differences between muscle-sparing and standard lateral thoracotomies. J Thorac Cardiovasc Surg. 112(5):1346–1350; discussion 50-1CrossRef Landreneau RJ, Pigula F, Luketich JD, Keenan RJ, Bartley S, Fetterman LS et al (1996) Acute and chronic morbidity differences between muscle-sparing and standard lateral thoracotomies. J Thorac Cardiovasc Surg. 112(5):1346–1350; discussion 50-1CrossRef
3.
Zurück zum Zitat Kavanagh BP, Katz J, Sandler AN (1994) Pain control after thoracic surgery. A review of current techniques. Anesthesiology 81(3):737–759CrossRef Kavanagh BP, Katz J, Sandler AN (1994) Pain control after thoracic surgery. A review of current techniques. Anesthesiology 81(3):737–759CrossRef
4.
Zurück zum Zitat Boisseau N, Rabary O, Padovani B, Staccini P, Mouroux J, Grimaud D et al (2001) Improvement of 'dynamic analgesia' does not decrease atelectasis after thoracotomy. Br J Anaesth 87(4):564–569CrossRef Boisseau N, Rabary O, Padovani B, Staccini P, Mouroux J, Grimaud D et al (2001) Improvement of 'dynamic analgesia' does not decrease atelectasis after thoracotomy. Br J Anaesth 87(4):564–569CrossRef
5.
Zurück zum Zitat Benedetti F, Amanzio M, Casadio C, Cavallo A, Cianci R, Giobbe R et al (1997) Control of postoperative pain by transcutaneous electrical nerve stimulation after thoracic operations. Ann Thorac Surg 63(3):773–776CrossRef Benedetti F, Amanzio M, Casadio C, Cavallo A, Cianci R, Giobbe R et al (1997) Control of postoperative pain by transcutaneous electrical nerve stimulation after thoracic operations. Ann Thorac Surg 63(3):773–776CrossRef
6.
Zurück zum Zitat Yegin A, Erdogan A, Kayacan N, Karsli B (2003) Early postoperative pain management after thoracic surgery; pre- and postoperative versus postoperative epidural analgesia: a randomised study. Eur J Cardiothorac Surg 24(3):420–424CrossRef Yegin A, Erdogan A, Kayacan N, Karsli B (2003) Early postoperative pain management after thoracic surgery; pre- and postoperative versus postoperative epidural analgesia: a randomised study. Eur J Cardiothorac Surg 24(3):420–424CrossRef
7.
Zurück zum Zitat Grant RP (1999) Con: every postthoracotomy patient does not deserve thoracic epidural analgesia. J Cardiothorac Vasc Anesth 13(3):355–357CrossRef Grant RP (1999) Con: every postthoracotomy patient does not deserve thoracic epidural analgesia. J Cardiothorac Vasc Anesth 13(3):355–357CrossRef
8.
Zurück zum Zitat Baidya DK, Khanna P, Maitra S (2014) Analgesic efficacy and safety of thoracic paravertebral and epidural analgesia for thoracic surgery: a systematic review and meta-analysis. Interact Cardiovasc Thorac Surg 18(5):626–635CrossRef Baidya DK, Khanna P, Maitra S (2014) Analgesic efficacy and safety of thoracic paravertebral and epidural analgesia for thoracic surgery: a systematic review and meta-analysis. Interact Cardiovasc Thorac Surg 18(5):626–635CrossRef
9.
Zurück zum Zitat Melzack R, Wall PD (1965) Pain mechanisms: a new theory. Science 150(3699):971–979CrossRef Melzack R, Wall PD (1965) Pain mechanisms: a new theory. Science 150(3699):971–979CrossRef
10.
Zurück zum Zitat Sbruzzi G, Silveira SA, Silva DV, Coronel CC, Plentz RD (2012) Transcutaneous electrical nerve stimulation after thoracic surgery: systematic review and meta-analysis of 11 randomized trials. Rev Bras Cir Cardiovasc 27(1):75–87CrossRef Sbruzzi G, Silveira SA, Silva DV, Coronel CC, Plentz RD (2012) Transcutaneous electrical nerve stimulation after thoracic surgery: systematic review and meta-analysis of 11 randomized trials. Rev Bras Cir Cardiovasc 27(1):75–87CrossRef
11.
Zurück zum Zitat Schulz KF, Altman DG, Moher D (2010) CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. J Pharmacol Pharmacother 1(2):100–107CrossRef Schulz KF, Altman DG, Moher D (2010) CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. J Pharmacol Pharmacother 1(2):100–107CrossRef
12.
Zurück zum Zitat Rakel B, Cooper N, Adams HJ et al (2010) New transient sham TENS device allows for investigator blinding while delivering a true placebo treatment. J Pain 11:230–238CrossRef Rakel B, Cooper N, Adams HJ et al (2010) New transient sham TENS device allows for investigator blinding while delivering a true placebo treatment. J Pain 11:230–238CrossRef
13.
Zurück zum Zitat Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A et al (2005) Standardisation of spirometry. Eur Respir J 26(2):319–338CrossRef Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A et al (2005) Standardisation of spirometry. Eur Respir J 26(2):319–338CrossRef
14.
Zurück zum Zitat Erdogan M, Erdogan A, Erbil N, Karakaya HK, Demircan A (2005) Prospective, randomized, placebo-controlled study of the effect of TENS on postthoracotomy pain and pulmonary function. World J Surg 29(12):1563–1570CrossRef Erdogan M, Erdogan A, Erbil N, Karakaya HK, Demircan A (2005) Prospective, randomized, placebo-controlled study of the effect of TENS on postthoracotomy pain and pulmonary function. World J Surg 29(12):1563–1570CrossRef
15.
Zurück zum Zitat Baki ED, Oz G, Kokulu S, Ulasli AM, Ela Y, Sivaci RG et al (2015) Comparison of transcutaneous electrical nerve stimulation and paravertebral block for postthoracotomy pain relief. Thorac Cardiovasc Surg 63(6):514–518CrossRef Baki ED, Oz G, Kokulu S, Ulasli AM, Ela Y, Sivaci RG et al (2015) Comparison of transcutaneous electrical nerve stimulation and paravertebral block for postthoracotomy pain relief. Thorac Cardiovasc Surg 63(6):514–518CrossRef
16.
Zurück zum Zitat Fiorelli A, Morgillo F, Milione R, Pace MC, Passavanti MB, Laperuta P et al (2012) Control of post-thoracotomy pain by transcutaneous electrical nerve stimulation: effect on serum cytokine levels, visual analogue scale, pulmonary function and medication. Eur J Cardiothorac Surg. 41(4):861–868; discussionCrossRef Fiorelli A, Morgillo F, Milione R, Pace MC, Passavanti MB, Laperuta P et al (2012) Control of post-thoracotomy pain by transcutaneous electrical nerve stimulation: effect on serum cytokine levels, visual analogue scale, pulmonary function and medication. Eur J Cardiothorac Surg. 41(4):861–868; discussionCrossRef
17.
Zurück zum Zitat Liu YC, Liao WS, Lien IN (1985) Effect of transcutaneous electrical nerve stimulation for post-thoracotomic pain. Taiwan Yi Xue Hui Za Zhi J Formosan Med Assoc 84(7):801–809 Liu YC, Liao WS, Lien IN (1985) Effect of transcutaneous electrical nerve stimulation for post-thoracotomic pain. Taiwan Yi Xue Hui Za Zhi J Formosan Med Assoc 84(7):801–809
18.
Zurück zum Zitat Warfield CA, Stein JM, Frank HA (1985) The effect of transcutaneous electrical nerve stimulation on pain after thoracotomy. Ann Thorac Surg 39(5):462–465CrossRef Warfield CA, Stein JM, Frank HA (1985) The effect of transcutaneous electrical nerve stimulation on pain after thoracotomy. Ann Thorac Surg 39(5):462–465CrossRef
19.
Zurück zum Zitat Erden S, Senol CS (2015) The effect of transcutaneous electrical nerve stimulation on post-thoracotomy pain. Contemp Nurse 51(2–3):163–170CrossRef Erden S, Senol CS (2015) The effect of transcutaneous electrical nerve stimulation on post-thoracotomy pain. Contemp Nurse 51(2–3):163–170CrossRef
20.
Zurück zum Zitat Solak O, Turna A, Pekcolaklar A, Metin M, Sayar A, Solak O et al (2007) Transcutaneous electric nerve stimulation for the treatment of postthoracotomy pain: a randomized prospective study. Thorac Cardiovasc Surg 55(3):182–185CrossRef Solak O, Turna A, Pekcolaklar A, Metin M, Sayar A, Solak O et al (2007) Transcutaneous electric nerve stimulation for the treatment of postthoracotomy pain: a randomized prospective study. Thorac Cardiovasc Surg 55(3):182–185CrossRef
21.
Zurück zum Zitat Chandra A, Banavaliker JN, Das PK, Hasti S (2010) Use of transcutaneous electrical nerve stimulation as an adjunctive to epidural analgesia in the management of acute thoracotomy pain. Indian J Anaesth 54(2):116–120CrossRef Chandra A, Banavaliker JN, Das PK, Hasti S (2010) Use of transcutaneous electrical nerve stimulation as an adjunctive to epidural analgesia in the management of acute thoracotomy pain. Indian J Anaesth 54(2):116–120CrossRef
22.
Zurück zum Zitat Ferreira FC, Issy AM, Sakata RK (2011) Assessing the effects of transcutaneous electrical nerve stimulation (TENS) in post-thoracotomy analgesia. Rev Bras Anestesiol 61(5):561–7, 308–10 Ferreira FC, Issy AM, Sakata RK (2011) Assessing the effects of transcutaneous electrical nerve stimulation (TENS) in post-thoracotomy analgesia. Rev Bras Anestesiol 61(5):561–7, 308–10
23.
Zurück zum Zitat Varela G, Brunelli A, Rocco G, Marasco R, Jiménez MF, Sciarra V, Aranda JL, Gatani T (2006) Predicted versus observed FEV1 in the immediate postoperative period after pulmonary lobectomy. Eur J Cardiothorac Surg 30(4):644–648CrossRef Varela G, Brunelli A, Rocco G, Marasco R, Jiménez MF, Sciarra V, Aranda JL, Gatani T (2006) Predicted versus observed FEV1 in the immediate postoperative period after pulmonary lobectomy. Eur J Cardiothorac Surg 30(4):644–648CrossRef
24.
Zurück zum Zitat Attri JPKR, Kaur H, Makhni R (2016) Post thoracotomy pain management: a review of current available modalities. Northern J ISA 1:7–10 Attri JPKR, Kaur H, Makhni R (2016) Post thoracotomy pain management: a review of current available modalities. Northern J ISA 1:7–10
Metadaten
Titel
Effects of Transcutaneous Electrical Nerve Stimulation on Pain, Pulmonary Function, and Respiratory Muscle Strength After Posterolateral Thoracotomy: A Randomized Controlled Trial
verfasst von
Hermann H. Husch
Guilherme Watte
Matheus Zanon
Gabriel Sartori Pacini
Daniella Birriel
Pauline L. Carvalho
Adriana Kessler
Graciele Sbruzzi
Publikationsdatum
08.02.2020
Verlag
Springer US
Erschienen in
Lung / Ausgabe 2/2020
Print ISSN: 0341-2040
Elektronische ISSN: 1432-1750
DOI
https://doi.org/10.1007/s00408-020-00335-4

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