title: High-frequency TENS in post-episiotomy pain relief in primiparous puerpere: a randomized, controlled trial.
abstract: OBJECTIVE
  We evaluated the effectiveness of high-frequency transcutaneous electrical nerve stimulation (TENS) as a pain relief resource for primiparous puerpere who had experienced natural childbirth with an episiotomy.
  
  
  METHODS
  A controlled, randomized clinical study was conducted in a Brazilian maternity ward. Forty puerpere were randomly divided into two groups: TENS high frequency and a no treatment control group. Post-episiotomy pain was assessed in the resting and sitting positions and during ambulation. An 11-point numeric rating scale was performed in three separate evaluations (at the beginning of the study, after 60 min and after 120 min). The McGill pain questionnaire was employed at the beginning and 60 min later. TENS with 100 Hz frequency and 75 µs pulse for 60 min was employed without causing any pain. Four electrodes ware placed in parallel near the episiotomy site, in the area of the pudendal and genitofemoral nerves.
  
  
  RESULTS
  An 11-point numeric rating scale and McGill pain questionnaire showed a significant statistical difference in pain reduction in the TENS group, while the control group showed no alteration in the level of discomfort. Hence, high-frequency TENS treatment significantly reduced pain intensity immediately after its use and 60 min later.
  
  
  CONCLUSIONS
  TENS is a safe and viable non-pharmacological analgesic resource to be employed for pain relief post-episiotomy. The routine use of TENS post-episiotomy is recommended.
authors.affiliation: College of Nursing, Faculty of Medicine, University of San Paulo, Ribeirão Preto, SP, Brazil. carolpitangui@hotmail.com
authors.forename: Ana Carolina Rodarti
authors.initials: AC
authors.lastname: Pitangui
authors.forename: Ligia
authors.initials: L
authors.lastname: de Sousa
authors.forename: Flávia Azevedo
authors.initials: FA
authors.lastname: Gomes
authors.forename: Cristine Homsi Jorge
authors.initials: CH
authors.lastname: Ferreira
authors.forename: Ana Márcia Spanó
authors.initials: AM
authors.lastname: Nakano
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil; D004841:Episiotomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D009321:Natural Childbirth / Q000009:adverse effects*; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D010298:Parity; D011247:Pregnancy; D011644:Puerperal Disorders / Q000601:surgery*; D016037:Single-Blind Method; D004561:Transcutaneous Electric Nerve Stimulation / Q000009:adverse effects; D055815:Young Adult