CJA
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Résumé de cet Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a scholarly reply
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Tsen, L. C.
Right arrow Articles by Bader, A. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Tsen, L. C.
Right arrow Articles by Bader, A. M.
Related Collections
Right arrow Obstetrical and Pediatric Anesthesia
Canadian Journal of Anesthesia 47:38-42 (2000)
© Canadian Anesthesiologists' Society, 2000
Reports of Investigation

Transcutaneous electrical nerve stimulation does not augment combined spinal epidural labour analgesia

Lawrence C. Tsen, MD, John Thomas, MD, Scott Segal, MD, Sanjay Datta, MD and Angela M. Bader, MD

From the Department of Anesthesia, Perioperative and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115 USA.

Address correspondence to: Lawrence Tsen MD. Phone: 617-732-8216; Fax: 617-277-2192; E-mail: lctsen{at}bics.bwh.harvard.edu)

Purpose: The spinal portion of the combined spinal epidural technique (CSE) provides dramatic but limited labour analgesia. Transcutaneous Electrical Nerve Stimulation (TENS) has been noted to modulate pain,1 in part by the frequency of stimulation chosen.2 Because nerve action potentials are blocked by local anesthestics in a frequency dependent manner,3 we speculated that a TENS unit could increase the quality and duration of the spinal portion of a CSE.

Methods: Forty parturients in active spontaneous labour, with a singleton, vertex, term fetus, requesting analgesia were enrolled in a randomized, double blind fashion to receive a standardized CSE with either an active or inactive TENS unit. Prior to CSE placement, TENS intensity thresholds were determined with electrodes placed on the paraspinus muscles at T10-L1, and S2-4; TENS settings for mode, cycle, and pulse width were standardized. Data were collected at timed intervals on pain (VAS), sensory level (pinprick), motor blockade (Bromage), cervical dilatation, and duration of analgesia, and at delivery on fetal and neonatal outcome.

Results: The duration of the spinal portion of the CSE did not differ between groups (TENS off 91.1 ± 33 [mean ± SD] vs TENS on 83.1 ± 28 min, P=.42). Kaplan-Meier survival analysis and Mantel-Cox log rank analysis showed no difference between the two treatments (P=.28). Analgesia was comparable throughout the first hour of spinal analgesia.

Conclusion: In healthy labouring parturients, the application of a TENS unit did not alter the quality or duration of labour analgesia provided by the spinal portion of CSE analgesia.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2000 by the Canadian Anesthesiologists' Society.