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Comparison of Transcutaneous Electrical Nerve Stimulation and Parasternal Block for Postoperative Pain Management after Cardiac Surgery


Affiliations
1 Department of Anesthesiology and Reanimation, Antalya Education and Research Hospital, Varlık Mahallesi, Kazim Karabekir Cadde, 07100 Antalya, Turkey
2 Department of Anesthesiology and Reanimation, Afyon Kocatepe University, Afyon, Turkey
3 Department of Cardiovascular Surgery, Antalya Education and Research Hospital, 07100 Antalya, Turkey
4 Department of Algology, Akdeniz University, 07100 Antalya, Turkey
 

Background: Parasternal block and transcutaneous electrical nerve stimulation (TENS) have been demonstrated to produce effective analgesia and reduce postoperative opioid requirements in patients undergoing cardiac surgery. Objectives: To compare the effectiveness of TENS and parasternal block on early postoperative pain after cardiac surgery. Methods: One hundred twenty patients undergoing cardiac surgery were enrolled in the present randomized, controlled prospective study. Patients were assigned to three treatment groups: parasternal block, intermittent TENS application, or a control group. Results: Pain scores recorded 4h, 5 h, 6 h, 7 h, and 8 h postoperatively were lower in the parasternal block group than in the TENS and control groups. Totalmorphine consumption was also lower in the parasternal block group than in the TENS and control groups. It was also significantly lower in the TENS group than in the control group. There were no statistical differences among the groups regarding the extubation time, rescue analgesic medication, length of intensive care unit stay, or length of hospital stay. Conclusions: Parasternal block was more effective than TENS in themanagement of early postoperative pain and the reduction of opioid requirements in patients who underwent cardiac surgery through median sternotomy.This trial is registered with Clinicaltrials.gov number NCT02725229.
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  • Comparison of Transcutaneous Electrical Nerve Stimulation and Parasternal Block for Postoperative Pain Management after Cardiac Surgery

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Authors

Nilgun Kavrut Ozturk
Department of Anesthesiology and Reanimation, Antalya Education and Research Hospital, Varlık Mahallesi, Kazim Karabekir Cadde, 07100 Antalya, Turkey
Elif Dogan Baki
Department of Anesthesiology and Reanimation, Afyon Kocatepe University, Afyon, Turkey
Ali Sait Kavakli
Department of Anesthesiology and Reanimation, Antalya Education and Research Hospital, Varlık Mahallesi, Kazim Karabekir Cadde, 07100 Antalya, Turkey
Ayca Sultan Sahin
Department of Anesthesiology and Reanimation, Antalya Education and Research Hospital, Varlık Mahallesi, Kazim Karabekir Cadde, 07100 Antalya, Turkey
Raif Umut Ayoglu
Department of Cardiovascular Surgery, Antalya Education and Research Hospital, 07100 Antalya, Turkey
Arzu Karaveli
Department of Anesthesiology and Reanimation, Antalya Education and Research Hospital, Varlık Mahallesi, Kazim Karabekir Cadde, 07100 Antalya, Turkey
Mustafa Emmiler
Department of Cardiovascular Surgery, Antalya Education and Research Hospital, 07100 Antalya, Turkey
Kerem Inanoglu
Department of Anesthesiology and Reanimation, Antalya Education and Research Hospital, Varlık Mahallesi, Kazim Karabekir Cadde, 07100 Antalya, Turkey
Bilge Karsli
Department of Algology, Akdeniz University, 07100 Antalya, Turkey

Abstract


Background: Parasternal block and transcutaneous electrical nerve stimulation (TENS) have been demonstrated to produce effective analgesia and reduce postoperative opioid requirements in patients undergoing cardiac surgery. Objectives: To compare the effectiveness of TENS and parasternal block on early postoperative pain after cardiac surgery. Methods: One hundred twenty patients undergoing cardiac surgery were enrolled in the present randomized, controlled prospective study. Patients were assigned to three treatment groups: parasternal block, intermittent TENS application, or a control group. Results: Pain scores recorded 4h, 5 h, 6 h, 7 h, and 8 h postoperatively were lower in the parasternal block group than in the TENS and control groups. Totalmorphine consumption was also lower in the parasternal block group than in the TENS and control groups. It was also significantly lower in the TENS group than in the control group. There were no statistical differences among the groups regarding the extubation time, rescue analgesic medication, length of intensive care unit stay, or length of hospital stay. Conclusions: Parasternal block was more effective than TENS in themanagement of early postoperative pain and the reduction of opioid requirements in patients who underwent cardiac surgery through median sternotomy.This trial is registered with Clinicaltrials.gov number NCT02725229.