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首页> 外文学位 >The effectiveness of transcutaneous electrical nerve stimulation (TENS) on postoperative pain with movement.
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The effectiveness of transcutaneous electrical nerve stimulation (TENS) on postoperative pain with movement.

机译：经皮神经电刺激（TENS）对术后运动性疼痛的有效性。

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摘要

The current therapy of intravenous PCA opioid administration is frequently inadequate for controlling pain after abdominal surgery, particularly during movements such as walking and deep breathing which directly impact recovery. This suggests supplemental strategies are needed. Recent evidence shows high frequency, high intensity TENS reduces movement-evoked pain by decreasing hyperalgesia. The purpose of this study was to test the effectiveness of intermittent, intense TENS as a supplement to pharmacologic analgesia on pain with movement and pain at rest after abdominal surgery and determine if its use during walking and vital capacity maneuvers improves these activities. TENS was compared to placebo TENS and pharmacologic analgesia alone (control) using a slit plot design with TENS intensity as an independent variable. Subjects' self-report of pain intensity was assessed (using a vertical, 21-point NRS), along with walking function (using three objective components: gait speed, gait distance, and level of assistance) and vital capacity. Repeated measures ANOVA procedures with Tukey follow-up tests revealed significant differences in 33 subjects' pain intensity scores during gait speed (p < .05) and vital capacity maneuvers (p < .01). TENS resulted in significantly better scores than the control during both activities and significantly less pain than placebo TENS during vital capacity. Significant differences were also found for gait speed (p < .05) and gait distance (p < .01) with TENS resulting in significantly better gait speeds and greater gait distances than the control and significantly greater gait distances than placebo TENS. However, effect sizes were small (.07--.58). Vital capacity and pain intensity at rest were not significantly different. The intensity of the TENS sensation subjects used varied widely but no significant differences were found between subjects who used high and low TENS intensities. These results suggest that TENS reduces pain intensity during walking and deep breathing and increases walking function postoperatively when used as a supplement to pharmacologic analgesia. However, the small effect sizes suggest selective use is most appropriate. The lack of effect on pain at rest supports the hypothesis that TENS works through reducing hyperalgesia. Further research is needed to investigate the impact of TENS on hyperalgesia around human surgical incisions.
机译：当前的静脉内注射PCA阿片类药物的治疗常常不足以控制腹部手术后的疼痛，尤其是在诸如步行和深呼吸之类的运动中，这直接影响恢复。这表明需要补充策略。最近的证据表明，高频率，高强度的TENS通过减少痛觉过敏来减轻运动引起的疼痛。这项研究的目的是测试间歇性，剧烈的TENS作为药物镇痛对运动疼痛和腹部手术后静止疼痛的补充的有效性，并确定其在步行和肺活量操纵中的使用是否能改善这些活动。使用狭缝图设计（以TENS强度作为独立变量）将TENS与安慰剂TENS和单独的药物镇痛（对照）进行比较。评估受试者对疼痛强度的自我报告（使用垂直的21点NRS）以及步行功能（使用三个客观组成部分：步态速度，步态距离和辅助水平）和肺活量。重复测量的ANOVA程序和Tukey跟踪测试显示，步态速度（p <.05）和肺活量动作（p <.01）期间33位受试者的疼痛强度评分存在显着差异。在两项活动中，TENS的得分均显着高于对照组，而在肺活量期间的疼痛明显低于安慰剂。与TENS相比，步态速度（p <.05）和步态距离（p <.01）也存在显着差异，与对照组相比，步态速度明显更好，步态距离更大，步态距离也明显大于安慰剂。但是，效果大小很小（.07-。58）。休息时的肺活量和疼痛强度无明显差异。使用的TENS感觉受试者的强度差异很大，但使用高和低TENS强度的受试者之间没有发现显着差异。这些结果表明，TENS用作药理镇痛剂的补充剂后，可减轻步行和深呼吸时的疼痛强度，并增加术后的步行功能。但是，较小的效应值表明选择性使用最为合适。对休息时疼痛缺乏影响的证据支持TENS通过减轻痛觉过敏起作用的假说。需要进一步的研究来研究TENS对人手术切口周围痛觉过敏的影响。

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  • 作者

    Rakel, Barbara Ann.;

  • 作者单位

    The University of Iowa.;

  • 授予单位 The University of Iowa.;
  • 学科 Health Sciences Nursing.
  • 学位 Ph.D.
  • 年度 2002
  • 页码 152 p.
  • 总页数 152
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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