title: Hi-TENS combined with PCA-morphine as post caesarean pain relief.
abstract: OBJECTIVE
  to examine effectiveness and overall opiate consumption between high-sensory transcutaneous electrical nerve stimulation (Hi-TENS) combined with patient-controlled analgesia with morphine and patient-controlled analgesia with morphine alone following elective (e.g. scheduled) caesarean birth.
  
  
  METHODS
  randomised, controlled study.
  
  
  METHODS
  a county hospital in south-west Sweden.
  
  
  METHODS
  42 multiparous women.
  
  
  RESULTS
  participants were randomly assigned and connected to patient-controlled analgesia with morphine alone or in combination with Hi-TENS apparatus. Levels of morphine consumed were calculated every third hour during the first 24 hours post partum. Pain and sedation were assessed by visual analogue scale at one, three, six, nine, 12 and 24 hours post partum. Total consumption of morphine differed significantly between the groups: morphine with TENS was 16.2 ± 12.6 mg and morphine alone was 33.1 ± 20.9 mg (p = 0.007). Assessment of pain relief showed no significant difference. Sedation differed significantly between the groups (p = 0.045), especially between three and 12 hours post partum (p = 0.011).
  
  
  CONCLUSIONS
  pain relief from a combination of Hi-TENS and patient-controlled analgesia with morphine was as effective as patient-controlled analgesia with morphine alone, produced less sedation and reduced morphine use by approximately 50%. Women undergoing a caesarean section should be given the opportunity to make an informed choice about post operative pain relief before surgery. A presumed benefit of this treatment combination is that the mother is more alert and better able to interact with her newborn during the first hours after birth without drowsiness due to large doses of opiates.
authors.affiliation: Department of Women's and Children's Health, IMCH, Akademiska Hospital/Uppsala University, Drottninggatan 4, 4th Floor, SE-75185 Uppsala, Sweden.pauline.binder@kbh.uu.se
authors.forename: Pauline
authors.initials: P
authors.lastname: Binder
authors.forename: Annica
authors.initials: A
authors.lastname: Gustafsson
authors.forename: Kerstin
authors.initials: K
authors.lastname: Uvnäs-Moberg
authors.forename: Eva
authors.initials: E
authors.lastname: Nissen
mesh_terms: D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D002585:Cesarean Section / Q000009:adverse effects; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D009020:Morphine / Q000008:administration & dosage*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000628:therapy*; D049590:Postpartum Period; D011247:Pregnancy; D013548:Sweden; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine