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首页> 外文期刊>European journal of emergency medicine: Official journal of the European Society for Emergency Medicine >Transcutaneous electrical nerve stimulation for relieving acute pain in the prehospital setting: A systematic review and meta-analysis of randomized-controlled trials
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Transcutaneous electrical nerve stimulation for relieving acute pain in the prehospital setting: A systematic review and meta-analysis of randomized-controlled trials

机译：经皮神经电刺激缓解院前环境中的急性疼痛：随机对照试验的系统评价和荟萃分析

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摘要

Although medics in many services are equipped with pharmacological analgesia, legislative or logistical restrictions in some systems result in the need to rely on nonpharmacological avenues for the management of acute pain. Transcutaneous electrical nerve stimulation (TENS) has been proposed as an alternative to analgesic medication that could be feasible and effective in the prehospital setting. The aim of this systematic review was to determine the effectiveness and safety of TENS when administered by medics to patients with acute pain in the prehospital setting. A systematic literature review was carried out to identify randomized-controlled trials investigating the safety and efficacy of TENS compared with 'sham' (placebo) TENS in the prehospital setting. Quality assessment of included studies was carried out to identify potential for bias. Qualitative and quantitative synthesis of results was performed to determine effectiveness and safety. The studies included were meta-analysed using a random-effects model to produce pooled results for comparison of the mean post-treatment pain scores using a visual analogue scale (VAS). Four studies were included in the analysis, all of which were prospective clinical trials of good methodological quality. Meta-analysis indicated that TENS produced a clinically significant reduction in severity of pain [mean VAS reduction 38 mm (95% confidence interval 28-44); P<0.0001] for patients with moderate-to-severe acute pain. TENS produced post-treatment mean pain scores that were significantly lower than 'sham' TENS [33 mm VAS (95% confidence interval 21-44); P<0.0001]. TENS was also effective in reducing acute anxiety secondary to pain. No safety risks were identified. When administered by medics in the prehospital setting to patients with acute pain, TENS appears to be an effective and safe nonpharmacological analgesic modality that should be considered by emergency medical services organizations in which pharmacological pain management is restricted or unavailable.
机译：尽管许多服务中的医生都配备了药理镇痛药，但某些系统中的立法或后勤限制导致需要依靠非药理学途径来治疗急性疼痛。已经提出经皮神经电刺激（TENS）作为止痛药的替代方法，在院前治疗中可能是可行和有效的。这项系统评价的目的是确定在院前环境中对急性疼痛患者进行药物治疗时TENS的有效性和安全性。进行了系统的文献综述，以鉴定随机对照试验，研究在院前环境中TENS与“假”（安慰剂）TENS相比的安全性和有效性。进行纳入研究的质量评估以发现潜在的偏见。对结果进行定性和定量综合以确定有效性和安全性。使用随机效应模型对纳入的研究进行荟萃分析，以产生汇总结果，以便使用视觉模拟量表（VAS）比较平均治疗后疼痛评分。分析中包括四项研究，所有这些都是具有良好方法学质量的前瞻性临床试验。荟萃分析表明，TENS使疼痛的严重程度发生了临床上的显着降低[平均VAS降低38毫米（95％置信区间28-44）; P <0.0001]用于中度至重度急性疼痛患者。 TENS产生的治疗后平均疼痛评分明显低于“假” TENS [33 mm VAS（95％置信区间21-44）; P <0.0001]。 TENS在减轻疼痛引起的急性焦虑方面也有效。没有发现安全隐患。当由院前环境中的医务人员给患有急性疼痛的患者服用时，TENS似乎是一种有效且安全的非药物止痛药，急诊医疗服务机构应考虑使用这种药物，而疼痛管理受到限制或无法使用。

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