Title

Efficacy of Transcutaneous Electrical Nerve Stimulation for Postoperative Pain, Pulmonary Function, and Opioid Consumption Following Cardiothoracic Procedures: A Systematic Review

Document Type

Peer-Reviewed Article

Publication Date

2020

Abstract

Objective

Transcutaneous electrical nerve stimulation (TENS) is a minimally invasive method for treating pain. In the most recent review published in 2012, TENS was associated with increased pain relief following cardiothoracic surgery when compared to standard multimodal analgesia. The purpose of this systematic review and meta‐analysis is to determine if adding TENS to current pain management practices decreases pain and analgesic use and improves pulmonary function for postcardiothoracic surgery patients.

Materials and Methods

CINAHL, MEDLINE, Cochrane Database of Systematic Reviews, PubMed, and ClinicalTrials.gov were searched using specific keywords. Covidence was used to screen, select studies, and extract data by two independent reviewers. The Cochrane Risk of Bias tool assessed risk of bias. Visual analog scale (VAS) and pulmonary function data were exported for meta‐analysis using a random effects model.

Results

The search yielded 38 articles. Eight randomized controlled trials met inclusion criteria for the literature review. Five studies were included in the meta‐analysis of pain at 24, 48, and 72 hours postoperatively. Data were analyzed using the standard mean difference (SMD). TENS had a significant impact on VAS at rest (−0.76 SMD [95% confidence interval, CI = −1.06 to −0.49], p < 0.00001) and with coughing (−1.11 SMD [95% CI = −1.64 to −0.56], p < 0.0001). FEV1 improved after 72 hours (1.00 SMD [95% CI = 0.66–1.35], p < 0.00001), as did forced vital capacity (1.16 SMD [95% CI = 0.23–2.10], p = 0.01).

Conclusion

The addition of TENS therapy to multimodal analgesia significantly decreases pain following cardiothoracic surgery, increases the recovery of pulmonary function, and decreases the use of analgesics.

Comments

Alexis Cardinali and David Celini are graduate students in the Physician Assistant program at Sacred Heart University.

DOI

10.1111/ner.13302

PMID

33215794

Publication

Neuromodulation Technology at the Neural Interface

Publisher

Wiley


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