Efeito da estimulação elétrica nervosa transcutânea no alívio da dor pós-operatória em cirurgias abdominais

Abstract

The pain in postoperative period of cholecystectomy can play a role in the reduction of pulmonary function and respiratory muscle strength. The patient mental state in preoperative can also influence in the postoperative impact of pain. The Transcutaneous Electrical Nerve Stimulation (TENS) is considered an adjunct therapy to multimodal handling for pain relief. Although, this therapy is little recommended because of low quality trials, inappropriate techniques, inadequate size of a sample and TENS underdosing. The purpose of this study was to verify if after cholecystectomy the TENS promotes pain reduction, increases respiratory muscle strength and pulmonary function and also, if pain catastrophizing and postoperative pain are associated. A first article was carried out with the title: Transcutaneous electrical nerve stimulation is superior than sham TENS for postoperative pain relief: a single-blinded placebo-controlled randomized controlled trial. It aimed to verify if TENS promotes a reduction of pain superior to placebo. We recruited 63 participants randomized into three groups: Control, Sham and Active. And it was concluded the Active TENS promoted a greater reduction of pain and a great effect of clinical relevance when compared to Sham TENS. A second article was made with the title “Effect of transcutaneous electrical nerve stimulation on abdominal postoperative pain, respiratory muscle strength, respiratory function and pain catastrophization: a randomized, placebo-controlled, double-blind clinical trial”. 22 participants were recruited and randomized in 2 groups, Active TENS and Sham TENS. The patients answered the pain catastrophizing questionnaire before entering the operating room. Before and after the TENS application the pain, the muscle pulmonary strength and the muscle function were measured. We conclude the Active TENS reduces the postoperative pain and has a moderate effect on clinical relevance when compared to Sham TENS. The usage of TENS does not promotes an increase on respiratory muscle strength or on pulmonary function. And also there is no association of pain catastrophizing and postoperative acute pain in laparoscopic cholecystectomy.