Use of transcutaneous electrical nerve stimulation in the control of postoperative chest pain after cardiac surgery

Abstract

The effect of continuous transcutaneous electrical nerve stimulation (TENS) on postoperative pain following median sternotomy was evaluated in 89 patients with severe chest pain who underwent cardiac surgery in a prospective, randomized, blinded trial. Pain was assessed by visual analog pain scores before and during treatment in each group. In the active TENS group, 79% of the patients were completely free of chest pain during rest at the end of 180 minutes ( P < 0.001). Among the remaining patients with TENS, 16% had slight pain not needing narcotic analgesics and 5% still had chest pain requiring narcotics. In the control group in which inactive TENS was used, the intensity of pain was reduced in 44% of the patients at the end of 90 minutes ( P < 0.001). However, this early placebo effect was noted to diminish with time and at the end of 180 minutes, 80% of the patients complained of severe chest pain and needed narcotics. These data suggest that TENS can be effective in controlling postoperative chest pain due to median sternotomy after cardiac surgery and its continuous application in the early postoperative period can reduce the need for narcotics.