title: TENS relieves acute posttraumatic hip pain during emergency transport.
abstract: BACKGROUND
  In Central Europe, ambulances for patients suffering from pain caused by nonlife-threatening trauma, such as hip fractures are staffed by medical personnel (medics) without physicians. Thus, there is an urgent need for nonpharmacological interventions that can be applied during the transport by basic life-support (BLS) medical personnel.
  
  
  METHODS
  In all, 101 patients were screened for participation in this randomized placebo-controlled double-blind study, and randomly assigned to two groups (verum and sham transcutaneous electrical nerve stimulation [TENS]). First, medic A recorded all baseline parameters and measurements, then medic B performed TENS in absence of medic A. At the end of transportation, medic A performed data collection. Each patient was asked to grade his/her pain and anxiety level on visual analog scales (VAS, 0 to 100 mm).
  
  
  RESULTS
  From 101 screened patients fulfilling the entry criteria, 29 declined consent and 9 had to be excluded from the analysis because of their final diagnosis. Therefore, the data from 30 patients (group 1, verum TENS) as well as from 33 patients (group 2 [control], sham TENS) were analyzed. No significant differences in potentially influencing factors were found before treatment. Pain scores upon arrival at the hospital differed significantly between group 1 and group 2 (p < 0.01). In group 1, pain reduction was observed between departure from the site of emergency and arrival at the hospital (VAS: 89 +/- 9 to 59 +/- 6 mm), whereas pain scores remained nearly unchanged in group 2 (VAS: 86 +/- 12 to 79 +/- 11 mm).
  
  
  CONCLUSIONS
  Our findings show that TENS is a valuable and fast-acting pain treatment under the difficult circumstances of "out-of-hospital rescue". Because of its lack of side effects, it could also be a valuable tool in the hospital.
authors.affiliation: Department of Anesthesia and Intensive Care, University of Vienna, Vienna, Austria. thomas.lang@meduniwien.ac.at
authors.forename: Thomas
authors.initials: T
authors.lastname: Lang
authors.forename: Renate
authors.initials: R
authors.lastname: Barker
authors.forename: Barbara
authors.initials: B
authors.lastname: Steinlechner
authors.forename: Burkhard
authors.initials: B
authors.lastname: Gustorff
authors.forename: Tivadar
authors.initials: T
authors.lastname: Puskas
authors.forename: Odette
authors.initials: O
authors.lastname: Gore
authors.forename: Alexander
authors.initials: A
authors.lastname: Kober
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000552:Ambulances; D000704:Analysis of Variance; D004311:Double-Blind Method; D004632:Emergency Medical Services; D004634:Emergency Medical Technicians; D005260:Female; D006620:Hip Fractures / Q000628:therapy*; D006801:Humans; D008297:Male; D010146:Pain / Q000517:prevention & control*; D004561:Transcutaneous Electric Nerve Stimulation