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

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.

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Abbreviations

TENS:

Transcutaneous electrical nerve stimulation

ICU:

Intensive care unit

FVC:

Forced vital capacity

RCT:

Randomized control trials

MAP:

Mean arterial pressure

RASS:

Richmond agitation-sedation scale

IG:

Intervention group

PG:

Placebo group

CG:

Control group

VAS:

Visual analogue scale

PFT:

Pulmonary function tests

FEV 1:

Forced expiratory volume in 1 second

FVC:

Forced vital capacity

IPmax:

Maximum inspiratory pressures

EPmax:

Maximum expiratory pressures

PC:

Epidural catheter

PVC:

Paravertebral catheter

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Correspondence to Graciele Sbruzzi.

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Husch, H.H., Watte, G., Zanon, M. et al. Effects of Transcutaneous Electrical Nerve Stimulation on Pain, Pulmonary Function, and Respiratory Muscle Strength After Posterolateral Thoracotomy: A Randomized Controlled Trial. Lung (2020). https://doi.org/10.1007/s00408-020-00335-4

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Keywords

  • Pain management
  • Pulmonary function
  • Thoracotomy
  • Transcutaneous electric nerve stimulation