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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



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).


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.


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.


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.

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Transcutaneous electrical nerve stimulation


Intensive care unit


Forced vital capacity


Randomized control trials


Mean arterial pressure


Richmond agitation-sedation scale


Intervention group


Placebo group


Control group


Visual analogue scale


Pulmonary function tests

FEV 1:

Forced expiratory volume in 1 second


Forced vital capacity


Maximum inspiratory pressures


Maximum expiratory pressures


Epidural catheter


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).

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