Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942011000500006
Brazilian Journal of Anesthesiology
Artigo Científico

Avaliação do efeito da estimulação nervosa elétrica transcutânea (TENS) para analgesia após toracotomia

Assessing the effects of transcutaneous electrical nerve stimulation (TENS) in post-thoracotomy analgesia

Fabiana Cristina Ferreira; Adriana Machado Issy; Rioko Kimiko Sakata

http://dx.doi.org/10.1590/S0034-70942011000500006 Braz J Anesthesiol, vol.61, n5, p.564-567, 2011
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Resumo

JUSTIFICATIVA E OBJETIVOS: A estimulação nervosa elétrica transcutânea (TENS) é uma modalidade frequentemente usada para o tratamento da dor musculoesquelética, mas também pode ser indicada em caso de analgesia pós-operatória. O objetivo deste estudo foi avaliar o efeito analgésico da TENS após toracotomia. MÉTODO: Foram incluídos 30 pacientes entre 18 e 60 anos submetidos à toracotomia para ressecção de câncer pulmonar, no segundo dia após a operação, alocados em dois grupos, G1 e G2. Os pacientes do G1 foram submetidos ao tratamento com TENS; nos do G2 (sem TENS), os eletrodos foram colocados, porém o aparelho não foi ligado. A TENS foi mantida por uma hora. A avaliação do efeito analgésico ocorreu através da escala analógica visual em três momentos: antes da aplicação (M0), imediatamente após o término do procedimento (M1) e uma hora depois (M2), com o paciente em repouso, em elevação dos membros superiores, com mudança de decúbito e tosse. RESULTADOS: A intensidade da dor em repouso foi maior em G2 imediatamente após o término, mas não uma hora após o procedimento. Com elevação dos membros superiores, mudança de decúbito e tosse, não houve diferença entre os grupos. CONCLUSÕES: Com aplicação de TENS durante uma hora no segundo dia após toracotomia em pacientes que receberam fentanil (50 µg) associada à bupivacaína (5 mL) em repouso, houve diminuição da intensidade da dor imediatamente após o término da aplicação; com elevação dos membros superiores e mudança de decúbito e tosse não houve redução da intensidade da dor.

Palavras-chave

CIRURGIA, DOR, TÉCNICAS DE ANALGESIA, TÉCNICAS DE ANALGESIA, TÉCNICAS DE MEDIÇÃO

Abstract

BACKGROUND AND OBJECTIVES: Transcutaneous electrical nerve stimulation (TENS) is commonly used to treat musculoskeletal pain, but it may also be indicated for postoperative analgesia. The objective of this study was to evaluate the analgesic effects of TENS on post-thoracotomy. METHODS: Thirty patients between 18 and 60 years of age undergoing thoracotomy for lung cancer resection on the second postoperative day were included in this study. Patients were divided into two groups (G1 and G2). G1 patients were treated with TENS; and in G2 (without TENS) electrodes were placed but the equipment was not turned on. TENS was maintained for one hour. The visual analogue scale was used to evaluate the analgesic effects on three moments: before TENS (M0), immediately after TENS (M1), and one hour later (M2), with the patient at rest, elevation of the upper limbs, change in decubitus, and coughing. RESULTS: The intensity of pain at rest was higher in G2 immediately after TENS, but not one hour after the procedure. There was no difference between both groups with elevation of the upper limbs, decubitus change, and coughing. CONCLUSIONS: With the use of TENS for one hour on the second post-thoracotomy day in patients who received fentanyl (50 µg) associated with bupivacaine (5 mL), a reduction in pain intensity was observed at rest immediately after TENS; with elevation of the upper limbs, change in decubitus, and coughing, a reduction in pain severity was not observed.

Keywords

Transcutaneous Electrical Nerve Stimulation, Thoracotomy, Pain, Postoperative, Pain Measurement

Referências

Ducharme J. Acute pain and pain control: state of the art. Ann Emerg Med. 2000;35:592-603.

Guevara-López U, Covarrubias-Gómez A, Rodríguez-Cabrera R. Parámetros de práctica para el manejo del dolor en México. Cir Ciruj. 2007;75:385-407.

Macrae WA. Chronic post-surgical pain: 10 years on. Br J Anaesth. 2008;101:77-86.

Akkaya T, Ozkan D. Chronic post-surgical pain. Agri. 2009;21:1-9.

Wildgaard K, Ravn J, Kehlet H. Chronic post-thoracotomy pain: a critical review of pathogenic mechanisms and strategies for prevention. Eur J Cardiothorac Surg. 2009;36:170-180.

Scott NA, Moga C, Harstall C. Managing low back pain in the primary care setting: the know-do gap. Pain Res Manag. 2010;15:392-400.

Pop T, Austrup H, Preuss R. Effect of TENS on pain relief in patients with degenerative disc disease in lumbosacral spine. Ortop Traumatol Rehabil. 2010;12:289-300.

Benedetti F, Amanzio M, Casadio C. Control of postoperative pain by transcutaneous eletrical nerve stimulation after thoracic operations. Ann Thorac Surg. 1997:773-776.

Hamza MA, White PF, Ahmed HE. Effect of the frequency of transcutaneous electrical nerve stimulation on the postoperative opioid analgesic requirement and recovery profile. Anesthesiology. 1999;91:1232-1238.

Sluka KA, Walsh D. Transcutaneous electrical nerve stimulation: Basic science mechanisms and clinical effectiveness. J Pain. 2003;4:109-121.

Sabino GS, Santos CMF, Francischi JN. Release of endogenous opioids following transcutaneous electric nerve stimulation in an experimental modelo for acute inflamatory pain. J Pain. 2008;9:157-163.

Poole D. Use of TENS in pain management: part two-how to use TENS. Nurs Times. 2007;103:28-29.

Erdogan M, Erdogan A, Erbil N. Prospective, randomized, placebo-controlled study of the effect of tens on postthoracotomy pain and pulmonary function. World J Surg. 2005;29:1563-1570.

Walsh DM, Howe TE, Johnson MI. Review: Transcutaneous electrical nerve stimulation for acute pain. Cochrane Database of Systematic Reviews. 2009.

Rakel B, Frantz R. Effectiveness of transcutaneous electrical nerve stimulation on postoperative pain with movement. J Pain. 2003;4:455-464.

Solak O, Turna A, Pekcolaklar A. Transcutaneous electric nerve stimulation for the treatment of postthoracotomy pain: a randomised prospective study. Heart Surg. 2009;12:E266-E271.

Chandra A, Banavaliker JN, Das PK. Use of transcutaneous electrical nerve stimulation as an adjunctive to epidural analgesia in the management of acute thoracotomy pain. Indian J Anaesth. 2010;54:116-20.

Cipriano G, Carvalho AC, Bernadelli GF. Short-term transcutaneous electrical nerve stimulation after cardiac surgery: effect on pain, pulmonary function and electrical muscle activity. Interact Cardiovasc Thorac Surg. 2008;7:539-543.

DeSantana JM, Sluka KA, Lauretti GR. High and low frequency TENS reduce postoperative pain intensity after laparoscopic tubal ligation. Clin J Pain. 2009;25:12-19.

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