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Aim of the study to assess the efficacy of two modes of transcutaneous electrical nerve stimulation (TENS) on relief of postoperative acute pain after hip fracture surgery.
The patients underwent undergo fractured hip surgery will be distributed into three groups with respect to the mode of postoperative analgesia applied: Group I (control): PCA only; group II: PCA plus lumbar plexus & sciatic nerve TENS (LS-TENS); group III: PCA plus surgical wound TENS (SW-TENS). TENS will be applied every 2 hours for 30-40 minutes during 48 hours postoperatively. Visual analogue score (VAS), Ramsey sedation scores, frequencies of PCA demand and counts of PCA delivery, as well as total analgesic consumption will be noted and compared between groups at various time intervals.
Visual analog scale (VAS) will be applied at 2 months postoperatively VAS and Mcgill pain questionnaire will be applied at the 6th and 24th months of the surgery to assess acute and chronic pain in the study population and the differences among groups.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group I (control) | No Intervention | Patient controlled analgesia (epidural fentanyl): PCA only | |
| group II | Experimental | PCA plus lumbar plexus & sciatic nerve transcutaneous electric nerve stimulation (LS-TENS) |
|
| group III | Experimental | PCA plus surgical wound transcutaneous electric nerve stimulation ( SW-TENS) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| transcutaneous electric nerve stimulation | Device | The TENS device will be applied for treatment periods of 30-40 minutes. The electrodes will be connected to the TENS device are stimulated in modulation mode and the parameters will be adjusted as pulse width of 60 μs,frequency of 120 Hz and the stimulation intensity as high as the subject could tolerate. Electrodes will be placed on either lumbar and sciatic nerve tracing unilaterally or on either side or parallel to the surgical wound. |
| Measure | Description | Time Frame |
|---|---|---|
| Visual analog scale for pain | Postoperative pain intensity is assessed using VAS for pain postoperatively. | 48 h postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Ramsey sedation scores | Sedation score is assessed for safety of epidural analgesic use. | 48 h postoperatively |
| Frequencies of PCA demand | Patient demand will be assessed by PCA demand |
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Inclusion Criteria: Adult patients will be scheduled for surgery due to hip fracture in Mustafa Kemal University Hospital will be included in the study.
Exclusion Criteria: Patients with a history of opioid analgesic abuse, or sensitivity to opioids, and those with clinically significant systemic (cardiovascular, pulmonary, hepatic, renal, neurologic etc.) diseases, will be excluded.
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| Name | Affiliation | Role |
|---|---|---|
| Menekse Oksar, M.D. | Mustafa Kemal University Medical School | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mustafa Kemal University Hospital | Hatay | 31100 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 10551571 | Result | Hamza MA, White PF, Ahmed HE, Ghoname EA. Effect of the frequency of transcutaneous electrical nerve stimulation on the postoperative opioid analgesic requirement and recovery profile. Anesthesiology. 1999 Nov;91(5):1232-8. doi: 10.1097/00000542-199911000-00012. | |
| 9249122 | Result | Wang B, Tang J, White PF, Naruse R, Sloninsky A, Kariger R, Gold J, Wender RH. Effect of the intensity of transcutaneous acupoint electrical stimulation on the postoperative analgesic requirement. Anesth Analg. 1997 Aug;85(2):406-13. doi: 10.1097/00000539-199708000-00029. |
| Label | URL |
|---|---|
| Use of TENS at mixed (2- and 100-Hz) frequencies of stimulation produced a slightly greater opioid-sparing effect than either low (2-Hz) or high (100 Hz) frequencies alone. | View source |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| D006620 | Hip Fractures |
| D000072836 | Surgical Wound |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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| ID | Term |
|---|---|
| D004561 | Transcutaneous Electric Nerve Stimulation |
| ID | Term |
|---|---|
| D004599 | Electric Stimulation Therapy |
| D013812 | Therapeutics |
| D026741 | Physical Therapy Modalities |
| D012046 | Rehabilitation |
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|
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| 48 h postoperatively |
| PCA delivery counts | Delivery count shows the actual PCA delivery. It is different from the demand. | 48 h postoperatively |
| Total fentanyl consumption | Total analgesic use during the study period | 48 h postoperatively |
| 22531569 | Result | Lan F, Ma YH, Xue JX, Wang TL, Ma DQ. Transcutaneous electrical nerve stimulation on acupoints reduces fentanyl requirement for postoperative pain relief after total hip arthroplasty in elderly patients. Minerva Anestesiol. 2012 Aug;78(8):887-95. Epub 2012 Apr 24. |
| 38639518 | Derived | Oksar M, Kalaci A, Turhanoglu S. Transcutaneous electrical nerve stimulation for reducing postoperative acute pain after hip fracture surgery: a double-blinded randomized clinical trial. Eur Rev Med Pharmacol Sci. 2024 Apr;28(7):2788-2796. doi: 10.26355/eurrev_202404_35907. |
| High-TAES (9-12 mA) produced a significant decrease in the PCA opioid requirement and opioid-related side effects after low intraabdominal surgery. | View source |
| TENS on specific acupoints is an effective and complementary approach to reduce postoperative analgesic requirement in elderly patients after total hip arthroplasty.. | View source |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D005264 | Femoral Fractures |
| D050723 | Fractures, Bone |
| D014947 | Wounds and Injuries |
| D025981 | Hip Injuries |
| D007869 | Leg Injuries |
| D000698 |
| Analgesia |
| D000760 | Anesthesia and Analgesia |