title: Effect of the frequency of transcutaneous electrical nerve stimulation on analgesia during extracorporeal shock wave lithotripsy.
abstract: In this prospective, randomised, sham controlled study, we set out to determine which transcutaneous electrical nerve stimulation (TENS) therapy modality (conventional vs acupuncture-like) is more effective as a supplementary analgesic regimen during extracorporeal shock wave lithotripsy (ESWL). Patients were prospectively randomised to one of three groups. In Group I (n=22), conventional TENS (impulse pattern: continuous at 80 Hz; intensity: 10-30 mA) was applied. In Group II (n=22) acupuncture-like TENS (impulse pattern: burst at 2 Hz; intensity: 15-50 mA) was applied. In Group III (n=22) (control group), stimulation was started at 1 mA and the intensity increased to no more than 10 mA until it produced a tickling sensation. Alfentanil was administered through a patient controlled analgesic device. Alfentanil consumption, hemodynamics and respiratory parameters, a 10-cm visual analogue pain scale, patient satisfaction, recovery and discharge times were evaluated. The consumption of alfentanil was significantly lower in Group I than in Groups II and III (P<0.0001). Pain scores were lower in Group I than in the other two groups (P<0.05). Patients in Group I were more satisfied with their analgesic medication than those in the other two groups (P<0.05). Both the time to an Aldrete score >8 and a modified post-anaesthetic discharge score >8 were significantly shorter in Group I (2.3+/-1.8, 49.1+/-14.6) than those of Groups II (4.6+/-2.2, 60.2+/-18.1) and III (4.9+/-2.8, 58.4+/-16.5) (P<0.0001 and P<0.05, respectively). We conclude that the use of conventional TENS is effective in decreasing the analgesic requirements and the incidence of alfentanil-related side effects during ESWL.
authors.affiliation: Department of Anaesthesiology, Dicle University Hospital, 21280 Diyarbakir, Turkey. alper@dicle.edu.tr
authors.forename: Alper
authors.initials: A
authors.lastname: Kararmaz
authors.forename: Sedat
authors.initials: S
authors.lastname: Kaya
authors.forename: Haktan
authors.initials: H
authors.lastname: Karaman
authors.forename: Selim
authors.initials: S
authors.lastname: Turhanoglu
mesh_terms: D000328:Adult; D015760:Alfentanil / Q000008:administration & dosage; D000698:Analgesia / Q000379:methods*; D005260:Female; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D004561:Transcutaneous Electric Nerve Stimulation; D014545:Urinary Calculi / Q000628:therapy*
chemical_list: D015760:Alfentanil