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ORIGINAL ARTICLE
Year : 2020  |  Volume : 34  |  Issue : 1  |  Page : 22-26

Effect of preoperative transcutaneous electrical nerve stimulation on intraoperative anesthetic drug consumption and pain scores in patients undergoing lumbar discectomy under general anesthesia


1 Department of Anaesthesiology and Critical Care, Army Hospital R&R, Delhi Cantt, New Delhi, India
2 Department of Neuroanaesthesiology and Critical Care, AIIMS, New Delhi, India
3 Department of Anaesthesiology and Critical Care, Armed Forces Medical College, Pune, Maharashtra, India

Correspondence Address:
Dr. Shalendra Singh
Department of Anaesthesiology and Critical Care, Armed Forces Medical College, Pune - 411 040, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijpn.ijpn_2_20

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Objective: Transcutaneous electrical nerve stimulation (TENS) is a common modality used to treat acute and chronic painful conditions. The aim of this study is to find out the effect of immediate preoperative TENS on intraoperative anesthetic drug consumption in patients undergoing lumbar discectomy under general anesthesia. Methods: Sixty patients undergoing lumbar discectomy were randomly divided into two study groups. In TENS group (Group T), TENS was applied for 1 h in the immediate preoperative period with 20 mA current, at 100 Hz frequency, in pulses of 250 μs on either side of the planned incision site. In Sham TENS group (Group S), TENS was applied for 1 h preoperatively to the patients, although with the current intensity set at “zero” mA. The pain intensity during rest as well as movement was recorded before and after TENS, by using the Visual Analog Scale (VAS) scores in both the groups. Intraoperatively, titrated doses of propofol were used to maintain a bispectral index value of 50 ± 5, and IV fentanyl was administered to maintain the heart rate and blood pressure within 20% of baseline values. Postoperatively, fentanyl 0.5 μg/kg IV was administered to achieve VAS of <4. Results: Application of TENS was found to significantly reduce the preoperative VAS score (P < 0.001). Intraoperatively, no difference in propofol and fentanyl consumption was observed in either group (P < 0.6) (P < 0.27). Recovery time and postoperative VAS scores recorded at various time intervals were comparable in both the groups. No difference in fentanyl consumption or rescue analgesia was noted in the postoperative period in both groups. Conclusions: Application of preoperative TENS provided immediate relief from pain, although without any significant decrease in the intraoperative or postoperative analgesic requirement. Furthermore, no difference was noted in the intraoperative anesthetic consumption.


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