A Comparative Study between Transcutaneous Electrical Nerve Stimulation and Fentanyl to Relieve Shoulder Pain during Laparoscopic Gynecologic Surgery under Spinal Anesthesia: A Randomized Clinical Trail

BACKGROUND: Traditionally, laparoscopic procedures have been performed under general anesthesia. Spinal anesthesia is an effective alternative to general anesthesia. However, one of the intraoperative complications of performing laparoscopic surgery under spinal anesthesia is shoulder pain. This stu...

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Autores principales: Asgari, Zahra, Tavoli, Zahra, Hosseini, Reihaneh, Nataj, Masoomeh, Tabatabaei, Fatemeh, Dehghanizadeh, Fatemeh, Haji-Amoo-Assar, Hosein, Sepidarkish, Mahdi, Montazeri, Ali
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2018
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878866/
https://www.ncbi.nlm.nih.gov/pubmed/29743962
http://dx.doi.org/10.1155/2018/9715142
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author Asgari, Zahra
Tavoli, Zahra
Hosseini, Reihaneh
Nataj, Masoomeh
Tabatabaei, Fatemeh
Dehghanizadeh, Fatemeh
Haji-Amoo-Assar, Hosein
Sepidarkish, Mahdi
Montazeri, Ali
author_facet Asgari, Zahra
Tavoli, Zahra
Hosseini, Reihaneh
Nataj, Masoomeh
Tabatabaei, Fatemeh
Dehghanizadeh, Fatemeh
Haji-Amoo-Assar, Hosein
Sepidarkish, Mahdi
Montazeri, Ali
author_sort Asgari, Zahra
collection PubMed
description BACKGROUND: Traditionally, laparoscopic procedures have been performed under general anesthesia. Spinal anesthesia is an effective alternative to general anesthesia. However, one of the intraoperative complications of performing laparoscopic surgery under spinal anesthesia is shoulder pain. This study aimed to compare the effect of transcutaneous electrical nerve stimulation (TENS) with fentanyl on pain relief in patients who underwent gynecologic laparoscopy under spinal anesthesia. METHODS: We conducted a prospective randomized clinical trial from May 2016 to March 2017. A sample of patients who underwent gynecological laparoscopy under spinal anesthesia was recruited. If they had shoulder pain, they randomly received either transcutaneous electrical nerve stimulation (TENS) or 50 mg of fentanyl. Pain intensity was measured using the single item visual analogue scale (VAS-10 cm) immediately before and 5, 10, 20, and 30 minutes after treatment. Also, the effect of higher doses of analgesia on pain relief was analyzed. RESULTS: In all, 80 patients (40 patients in each group) were entered into the study. The mean pain intensity score was 9.02 ± 1.32 in the TENS group and 8.95 ± 1.33 in the fentanyl group at baseline (P = 0.80). Repeated measures analysis of variance indicated that there was no significant difference on overall pain scores between the two treatment groups adjusted for age, BMI, total analgesia used, and baseline pain score (F (1, 74) = 1.44, P = 0.23). The use of analgesic drugs in the TENS group was significantly higher than the fentanyl group (P = 0.01). In addition, we found that nine patients (22.5%) complained of nausea/vomiting in the TENS group compared to thirteen patients (32.5%) in the fentanyl group (P = 0.31). CONCLUSIONS: The findings indicated that TENS was not superior to fentanyl for pain relief in laparoscopic surgery. It seems that the correct use of TENS parameters might merit further investigation. This trial is registered with: IRCT2016031216765N3.
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spelling pubmed-58788662018-05-09 A Comparative Study between Transcutaneous Electrical Nerve Stimulation and Fentanyl to Relieve Shoulder Pain during Laparoscopic Gynecologic Surgery under Spinal Anesthesia: A Randomized Clinical Trail Asgari, Zahra Tavoli, Zahra Hosseini, Reihaneh Nataj, Masoomeh Tabatabaei, Fatemeh Dehghanizadeh, Fatemeh Haji-Amoo-Assar, Hosein Sepidarkish, Mahdi Montazeri, Ali Pain Res Manag Clinical Study BACKGROUND: Traditionally, laparoscopic procedures have been performed under general anesthesia. Spinal anesthesia is an effective alternative to general anesthesia. However, one of the intraoperative complications of performing laparoscopic surgery under spinal anesthesia is shoulder pain. This study aimed to compare the effect of transcutaneous electrical nerve stimulation (TENS) with fentanyl on pain relief in patients who underwent gynecologic laparoscopy under spinal anesthesia. METHODS: We conducted a prospective randomized clinical trial from May 2016 to March 2017. A sample of patients who underwent gynecological laparoscopy under spinal anesthesia was recruited. If they had shoulder pain, they randomly received either transcutaneous electrical nerve stimulation (TENS) or 50 mg of fentanyl. Pain intensity was measured using the single item visual analogue scale (VAS-10 cm) immediately before and 5, 10, 20, and 30 minutes after treatment. Also, the effect of higher doses of analgesia on pain relief was analyzed. RESULTS: In all, 80 patients (40 patients in each group) were entered into the study. The mean pain intensity score was 9.02 ± 1.32 in the TENS group and 8.95 ± 1.33 in the fentanyl group at baseline (P = 0.80). Repeated measures analysis of variance indicated that there was no significant difference on overall pain scores between the two treatment groups adjusted for age, BMI, total analgesia used, and baseline pain score (F (1, 74) = 1.44, P = 0.23). The use of analgesic drugs in the TENS group was significantly higher than the fentanyl group (P = 0.01). In addition, we found that nine patients (22.5%) complained of nausea/vomiting in the TENS group compared to thirteen patients (32.5%) in the fentanyl group (P = 0.31). CONCLUSIONS: The findings indicated that TENS was not superior to fentanyl for pain relief in laparoscopic surgery. It seems that the correct use of TENS parameters might merit further investigation. This trial is registered with: IRCT2016031216765N3. Hindawi 2018-03-18 /pmc/articles/PMC5878866/ /pubmed/29743962 http://dx.doi.org/10.1155/2018/9715142 Text en Copyright © 2018 Zahra Asgari et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Asgari, Zahra
Tavoli, Zahra
Hosseini, Reihaneh
Nataj, Masoomeh
Tabatabaei, Fatemeh
Dehghanizadeh, Fatemeh
Haji-Amoo-Assar, Hosein
Sepidarkish, Mahdi
Montazeri, Ali
A Comparative Study between Transcutaneous Electrical Nerve Stimulation and Fentanyl to Relieve Shoulder Pain during Laparoscopic Gynecologic Surgery under Spinal Anesthesia: A Randomized Clinical Trail
title A Comparative Study between Transcutaneous Electrical Nerve Stimulation and Fentanyl to Relieve Shoulder Pain during Laparoscopic Gynecologic Surgery under Spinal Anesthesia: A Randomized Clinical Trail
title_full A Comparative Study between Transcutaneous Electrical Nerve Stimulation and Fentanyl to Relieve Shoulder Pain during Laparoscopic Gynecologic Surgery under Spinal Anesthesia: A Randomized Clinical Trail
title_fullStr A Comparative Study between Transcutaneous Electrical Nerve Stimulation and Fentanyl to Relieve Shoulder Pain during Laparoscopic Gynecologic Surgery under Spinal Anesthesia: A Randomized Clinical Trail
title_full_unstemmed A Comparative Study between Transcutaneous Electrical Nerve Stimulation and Fentanyl to Relieve Shoulder Pain during Laparoscopic Gynecologic Surgery under Spinal Anesthesia: A Randomized Clinical Trail
title_short A Comparative Study between Transcutaneous Electrical Nerve Stimulation and Fentanyl to Relieve Shoulder Pain during Laparoscopic Gynecologic Surgery under Spinal Anesthesia: A Randomized Clinical Trail
title_sort comparative study between transcutaneous electrical nerve stimulation and fentanyl to relieve shoulder pain during laparoscopic gynecologic surgery under spinal anesthesia: a randomized clinical trail
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878866/
https://www.ncbi.nlm.nih.gov/pubmed/29743962
http://dx.doi.org/10.1155/2018/9715142
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