title: Transcutaneous Electrical Nerve Stimulation Reduces Post-Thoractomy Ipsilateral Shoulder Pain. A Prospective Randomized Study.
abstract: OBJECTIVE
  The patient's position during an axillary thoracotomy can cause postoperative pain and decrease mobility of the ipsilateral shoulder. In this study, we assessed whether the implementation of a standardized analgesia program using transcutaneous electrical nerve stimulation (TENS) decreases local pain and improves ipsilateral shoulder mobility.
  
  
  METHODS
  Randomized, single-blind, single-center clinical trial of 50 patients who had undergone anatomical lung resection via axillary muscle-sparing thoracotomy. Patients were treated with TENS devices for 30 minutes every 8 hours, beginning on postoperative day 1. Pain and mobility of the affected limb were recorded at the same time on postoperative days 1 through 3. A visual analogue scale was used for pain assessment and shoulder mobility was assessed with a goniometer. Results were compared using a non-parametric test.
  
  
  RESULTS
  Twenty-five patients were randomized to each group. Mean age of the control group was 62.7±9.3 years and 63.4±10.2 years in the experimental group. Shoulder mobility parameters were similar in both groups on all postoperative days. However, pain during flexion significantly decreased on day 2 (P=.03) and day 3 (P=.04) in the experimental group.
  
  
  CONCLUSIONS
  The use of TENS decreases pain from shoulder flexion in patients undergoing axillary thoracotomy for pulmonary resection.
authors.affiliation: Servicio de Cirugía Torácica, Hospital Clínico Universitario de Salamanca, Salamanca, España. Electronic address: peg@usal.es.
authors.forename: Pedro
authors.initials: P
authors.lastname: Esteban González
authors.affiliation: Servicio de Cirugía Torácica, Hospital Clínico Universitario de Salamanca, Salamanca, España.
authors.forename: Nuria M
authors.initials: NM
authors.lastname: Novoa
authors.affiliation: Servicio de Cirugía Torácica, Hospital Clínico Universitario de Salamanca, Salamanca, España.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Varela
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D011446:Prospective Studies; D020127:Recovery of Function; D012785:Shoulder Joint; D020069:Shoulder Pain / Q000209:etiology* / Q000628:therapy*; D016037:Single-Blind Method; D013908:Thoracotomy / Q000009:adverse effects*; D004561:Transcutaneous Electric Nerve Stimulation
keywords: Dolor de hombro; Estimulación eléctrica nerviosa transcutánea; Muscle-sparing thoracotomy; Post-thoracotomy shoulder pain; Rango de movilidad del hombro; Shoulder range of motion; Toracotomía lateral sin sección muscular; Transcutaneous electrical nerve stimulation