title: High and low frequency TENS reduce postoperative pain intensity after laparoscopic tubal ligation: a randomized controlled trial.
abstract: BACKGROUND
  Transcutaneous electrical nerve stimulation (TENS) is an effective adjunctive therapy for postoperative pain; however, effects of different frequencies of stimulation have not been systematically investigated. Laparoscopic sterilization (LS) causes significant pain in the early postoperative period and requires substantial postoperative medication. Therefore, we studied the effects of TENS on postoperative pain after LS through placement of Yoon fallopian rings in a prospective, randomized, double-blinded, and placebo-controlled study.
  
  
  METHODS
  Sixty-four patients undergoing LS for uterine tube ligation were randomly allocated to receive either active TENS or placebo TENS. Postoperative pain was evaluated using a standard 11-point numeric rating scale and the McGill Pain Questionnaire (MPQ)-pain rating index and number of words chosen. Both high frequency (100 Hz) and low frequency (4 Hz) TENS, at strong, but comfortable sensory intensity, were applied for 20 minutes through 4 electrodes placed around the surgical incision immediately after surgery. Pain was assessed before and after application of TENS when patients were at postanesthesia care unit (PACU).
  
  
  RESULTS
  Both high and low frequency TENS significantly decreased postoperative pain intensity when compared with before administration of TENS using the numeric rating scale (P=0.001), pain rating index (P=0.001), and number of words chosen (P=0.001) compared with placebo TENS (P=0.001). TENS in combination with standard pharmacologic analgesic treatment was efficacious for postoperative pain relief after LS.
  
  
  CONCLUSIONS
  We recommend regular use of multimodal therapy with TENS and analgesic drugs after LS with placement of Yoon rings.
authors.affiliation: Graduate Program in Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA. josimari-desantana@uiowa.edu
authors.forename: Josimari M
authors.initials: JM
authors.lastname: Desantana
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Sluka
authors.forename: Gabriela Rocha
authors.initials: GR
authors.lastname: Lauretti
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D003627:Data Interpretation, Statistical; D004311:Double-Blind Method; D004566:Electrodes; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000628:therapy*; D013246:Sterilization, Tubal; D011795:Surveys and Questionnaires; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000700:Analgesics