Transcutaneous electrical nerve stimulation after thoracic surgery: systematic review and meta-analysis of 11 randomized trials.
OBJECTIVE
To evaluate the effects of transcutaneous electric nerve stimulation (TENS) on pain and pulmonary function during the postoperative period after thoracic surgery by performing a systematic review and meta-analysis of randomized trials.


METHODS
The search strategy included MEDLINE, PEDro, Cochrane CENTRAL, EMBASE and LILACS, besides a manual search, from inception to August, 2011. Randomized trials were included, comparing TENS associated or not with pharmacological analgesia vs. placebo TENS associated or not with pharmacological analgesia or vs. pharmacological analgesia alone to assess pain (visual analog scale - VAS) and/or pulmonary function represented by forced vital capacity (FVC) in postoperative thoracic surgery patients (pulmonary or cardiac with approach by thoracotomy or sternotomy).


RESULTS
Of the 2.489 articles identified, 11 studies were included. In the approach by thoracotomy, TENS associated with pharmacological analgesia reduced pain compared to the placebo TENS associated with pharmacological analgesia (VAS -1.29; CI95%: -1.94 to - 0.65). In the approach by sternotomy, TENS associated with pharmacological analgesia also reduced pain compared to the placebo TENS associated with pharmacological analgesia (VAS -1.33; 95%CI: -1.89 to 0.77) and compared to pharmacological analgesia alone (VAS -1.23; 95%CI: -1.79 to -0.67). There was no significant improvement in FVC (0.12 L; 95%CI: -0.27 to 0.51).


CONCLUSIONS
TENS associated with pharmacological analgesia provides pain relief compared to the placebo TENS in postoperative thoracic surgery patients both approached by thoracotomy and sternotomy. In the sternotomy it also provides more effective pain relief compared to pharmacological analgesia alone, but has no significant effect on pulmonary function.
Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre, Brazil.
Graciele
G
Sbruzzi
Scheila Azeredo
SA
Silveira
Diego Vidaletti
DV
Silva
Christian Correa
CC
Coronel
Rodrigo Della Méa
RD
Plentz
D000328:Adult; D000368:Aged; D006801:Humans; D008875:Middle Aged; D010149:Postoperative Pain / Q000503:physiopathology / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D056346:Sternotomy / Q000009:adverse effects*; D013908:Thoracotomy / Q000009:adverse effects*; D004561:Transcutaneous Electric Nerve Stimulation / Q000009:adverse effects / Q000379:methods*; D014797:Vital Capacity / Q000502:physiology