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The objective of this study is to detect the effect of trans-cranial direct current stimulation on postoperative pain and opioid consumption in total knee arthro-plasty patients. Fifty patients undergoing unilateral TKA will be randomly assigned to receive 4 sessions, total of 80 minutes of real (n=25) or sham tDCS (n=25). Stimulation will be given on 4 consecutive postoperative days, group 1 will receive real stimulation with the active electrode over the leg representation of the motor strip (cortical motor area of the leg) and the reference electrode over the arm, group 2 will receive Sham tDCS. Pain level will be evaluated according to visual analogue scale (VAS) and LANSS pain scale before (base line) after 1st, 2nd, 3rd and 4th sessions.
The study aims to to detect the effect of trans-cranial direct current stimulation on postoperative pain and opioid consumption in total knee arthro-plasty patients.
Fifty patients undergoing unilateral TKA will be randomly assigned to receive 4 sessions, total of 80 minutes of real (n=25) or sham tDCS (n=25). Stimulation will be given on 4 consecutive postoperative days, group 1 will receive real stimulation with the active electrode over the leg representation of the motor strip (cortical motor area of the leg) and the reference electrode over the arm, group 2 will receive Sham tDCS.
Pain level will be evaluated according to visual analogue scale (VAS) and LANSS pain scale before (baseline) after 1st, 2nd, 3rd and 4th sessions.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Real tDCS | Active Comparator | Direct current stimulation using anodal electrode, 25 patients received real anodal tDCS on the motor area for 20 minutes every day for 4 consecutive days. |
|
| Sham tDCS | Sham Comparator | Sham direct current stimulation, 25 patients received sham anodal tDCS on the motor area for 20 minutes every day for 4 consecutive days. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| tDCS | Device | 25 patients received real anodal tDCS on the motor area for 20 minutes every day for 4 consecutive days. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Opioids consumption per 24 hours at the 4th day postoperative | Measuring the consumption dose of opioids per 24 hours at the fourth day | day 4 postoperative |
| Opioids consumption / 24 hours at the third day postoperative | Measuring the consumption dose of opioids per 24 hours at the third day postoperative | day 3 postoperative |
| Opioids Consumption / 24 hours at the second day postoperative | Measuring the consumption dose of opioids per 24 hours at the second day post-operative | day 2 postoperative |
| Opioids consumption / 24 hours at the 1st day postoperative | Measuring the consumption dose of opioids per 24 hours at the 1st day postoperative | 1st day postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| Opioid side effects | Record Opioid-related adverse effects (nausea and/or vomiting and the need for alizapride 50mg IV). | 4th post operative day |
| Pain assessment by VAS | Pain Assessment using Visual Analogue Scale |
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Inclusion Criteria:
Exclusion Criteria:
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28440034 | Derived | Khedr EM, Sharkawy ESA, Attia AMA, Ibrahim Osman NM, Sayed ZM. Role of transcranial direct current stimulation on reduction of postsurgical opioid consumption and pain in total knee arthroplasty: Double randomized clinical trial. Eur J Pain. 2017 Sep;21(8):1355-1365. doi: 10.1002/ejp.1034. Epub 2017 Apr 25. |
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| ID | Term |
|---|---|
| D065908 | Transcranial Direct Current Stimulation |
| ID | Term |
|---|---|
| D004599 | Electric Stimulation Therapy |
| D013812 | Therapeutics |
| D003295 | Convulsive Therapy |
| D013000 | Psychiatric Somatic Therapies |
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| Sham tDCS | Device | 25 patients received sham anodal tDCS on the motor area for 20 minutes every day for 4 consecutive days. |
|
| 3rd postoperative day |
| Pain assessment by VAS | Pain Assessment using Visual Analogue Scale | 2nd postoperative day |
| Pain assessment by VAS | Pain Assessment using Visual Analogue Scale | 1st postoperative days |
| D004191 | Behavioral Disciplines and Activities |
| D004597 | Electroshock |
| D011580 | Psychological Techniques |