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Title: A randomized controlled trial of auricular transcutaneous electrical nerve stimulation for managing posthysterectomy pain
Authors: Tsang, HC
Lam, CS
Chu, PW
Yap, J
Fung, TY
Cheing, GLY 
Issue Date: 2011
Source: Evidence-based complementary and alternative medicine, 2011, v. 2011, 276769, p. 1-9
Abstract: Background. A patient- and assessor-blinded randomized controlled trial was conducted to examine the effectiveness of auricular transcutaneous electrical nerve stimulation (TENS) in relieving posthysterectomy pain.
Method. Forty-eight women who had undergone a total abdominal hysterectomy were randomly assigned into three groups (n=16 each) to receive either (i) auricular TENS to therapeutic points (the true TENS group), (ii) auricular TENS to inappropriate points (the sham TENS group), or (iii) 20 minutes of bed rest with no stimulation (the control group). The intervention was delivered about 24 hours after the operation. A visual analogue scale was used to assess pain while resting (VAS-rest) and upon huffing (VAS-huff) and coughing (VAS-cough), and the peak expiratory flow rate (PEFR) was assessed before and at 0, 15, and 30 minutes after the intervention.
Result. As compared to the baseline, only the true TENS group reported a significant reduction in VAS-rest (P=.001), VAS-huff (P=.004), and VAS-cough (P=.001), while no significant reduction in any of the VAS scores was seen in the sham TENS group (all P>.05). In contrast, a small rising trend was observed in the VAS-rest and VAS-huff scores of the control group, while the VAS-cough score remained largely unchanged during the period of the study. A between-group comparison revealed that all three VAS scores of the true TENS group were significantly lower than those of the control group at 15 and 30 minutes after the intervention (all P<.02). No significant between-group difference was observed in PEFR at any point in time.
Conclusion. A single session of auricular TENS applied at specific therapeutic points significantly reduced resting (VAS-rest) and movement-evoked pain (VAS-huff, VAS-cough), and the effects lasted for at least 30 minutes after the stimulation. The analgesic effects of auricular TENS appeared to be point specific and could not be attributed to the placebo effect alone. However, auricular TENS did not produce any significant improvement in the performance of PEFR.
Keywords: Postoperative pain
Abdominal hysterectomy
Analgesic requirement
Electroacupuncture
Hyperalgesia
Acupuncture
Management
Threshold
Mechanisms
Movement
Publisher: Hindawi Publishing Corporation
Journal: Evidence-based complementary and alternative medicine 
ISSN: 1741-427X
EISSN: 1741-4288
DOI: 10.1155/2011/276769
Rights: Copyright © 2011 Hin Cheung Tsang et al. 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.
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