title: HI-TENS reduces moderate-to-severe pain associated with most wound care procedures: a pilot study.
abstract: This study systematically examined pain associated with wound care procedures (WCPs) and evaluated the effectiveness of high-intensity transcutaneous electrical nerve stimulation (HI-TENS) for reducing this pain in a two-phase design. Phase 1 (N = 57) examined patient, wound, and procedural factors, as well as analgesic intake, associated with WCPs. Pain during the WCPs was rated on a 0-10 numerical scale. Subjects reported a mean pain of 6.0 (standard deviation 3.04) during Phase 1, with 43 (75.4%) subjects experiencing moderate or severe pain (i.e., ≥4). Subjects who received opioid and/or nonopioid analgesia 1 hr before or during the WCPs (36.8%) reported significantly higher pain levels than those who had not received analgesia (p = .013). In Phase 2, 23 subjects with ≥4 pain during Phase 1 had HI-TENS applied to the area surrounding the wound during the WCPs. HI-TENS significantly reduced WCP pain by a mean of 2.0 (±2.31; effect size = 0.67; p = .001). This effect was significant for subjects with severe Phase 1 pain (i.e., ≥8; effect size = 1.00; p = .007) but not for subjects with moderate Phase 1 pain (i.e., 4-7; effect size = 0.40; p = .053). These findings demonstrate that pain during WCPs is a significant problem, that nurses appropriately administer analgesics but these are not sufficient, and that using HI-TENS may further reduce pain, particularly in patients experiencing severe WCP pain.
authors: College of Nursing, University of Iowa, Iowa City, Iowa, USA sue-gardner@uiowa.edu.
authors: Sue E
authors: SE
authors: Gardner
authors: College of Nursing, University of Iowa, Iowa City, Iowa, USA.
authors: Nicole P
authors: NP
authors: Blodgett
authors: Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA.
authors: Stephen L
authors: SL
authors: Hillis
authors: College of Nursing, University of Iowa, Iowa City, Iowa, USA.
authors: Ellen
authors: E
authors: Borhart
authors: College of Nursing, University of Iowa, Iowa City, Iowa, USA.
authors: Lynna
authors: L
authors: Malloy
authors: University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
authors: Linda
authors: L
authors: Abbott
authors: University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
authors: Pat
authors: P
authors: Pezzella
authors: University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
authors: Marge
authors: M
authors: Jensen
authors: University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
authors: Teresa
authors: T
authors: Sommer
authors: Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA.
authors: Kathleen A
authors: KA
authors: Sluka
authors: College of Nursing, University of Iowa, Iowa City, Iowa, USA.
authors: Barbara A
authors: BA
authors: Rakel
mesh_terms: D000700:Analgesics / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010865:Pilot Projects; D004561:Transcutaneous Electric Nerve Stimulation; D014947:Wounds and Injuries / Q000628:therapy*
chemical_list: D000700:Analgesics
keywords: TENS; nonpharmacologic pain interventions; open wounds; procedural pain; wound dressing changes; wound pain