针刺联合经皮神经电刺激治疗肝豆状核变性吞咽困难的临床研究

目的探讨肝豆状核变性患者吞咽困难的有效治疗方案。方法将60例肝豆状核变性合并吞咽困难患者分为3组:A组(针刺+经皮神经电刺激+吞咽功能训练),B组(针刺+吞咽功能训练),C组(经皮神经电刺激+吞咽功能训练),1个疗程15d,共治疗2个疗程。应用洼田饮水试验及标准化床边吞咽功能检查表(SSA)进行疗效评价。结果第1个疗程后A组疗效明显优于B组、C组,A组的两种评分差值明显高于B组、C组(P0.01)。第2个疗程后3组之间饮水试验及SSA评分无显著性差异(P0.05)。结论针刺联合经皮神经电刺激和吞咽功能训练综合治疗能够有效改善肝豆状核变性患者的吞咽功能。     

外周神经阻滞麻醉在糖尿病周围神经病变患者中应用的研究进展

外周神经阻滞麻醉的合理应用可避免全身麻醉或椎管内麻醉相关并发症,促进患者康复,其在糖尿病周围神经病变(diabetic peripheral neuropathy, DPN)患者中的应用存在一定优势并日益受到重视。但由于DPN患者的外周神经已存在基础病变,应用外周神经阻滞麻醉是否增加神经损伤风险引起广泛关注。本文将对外周神经阻滞麻醉在DPN患者中的优势、麻醉实施、局麻药浓度和佐剂的选择、降低麻醉相关并发症风险等方面内容进行阐述,旨在为临床实践提供依据,提高外周神经阻滞麻醉在DPN患者中应用的安全性。     

经皮神经电刺激对弛缓型脑性瘫痪患儿的效果

目的探讨经皮神经电刺激对弛缓型脑瘫患儿的临床疗效及表面肌电变化。方法40 例弛缓型脑瘫患儿分为治疗组(n=20)和对照组(n=20),两组均接受30 d 的常规康复训练,治疗组另外对股四头肌进行经皮神经电刺激治疗,每周5 次,治疗30d。治疗前后按改良Lovett 肌力测定法进行股四头肌肌力测定(Lovett 分级),粗大运动功能测试量表(GMFM)评定患儿粗大运动发育情况,同时运用表面肌电仪测定股四头肌自主收缩位表面肌电积分值(iEMG)和表面肌电信号均方根值(RMS)的变化。结果治疗后两组脑瘫患儿的Lovett 分级、GMFM评分、iEMG和RMS均较治疗前改善(P<0.05),且治疗组优于对照组(P<0.05)。结论经皮神经电刺激有利于提高弛缓型脑瘫患儿股四头肌肌张力,增强肌力,改善运动功能。     

Transcutaneous Electrical Nerve Stimulation for Phantom Pain and Stump Pain in Adult Amputees

Abstract Following amputation, 50% to 90% of individuals experience phantom and/or stump pain. Transcutaneous electrical nerve stimulation (TENS) may prove to be a useful adjunct analgesic intervention, although a recent systematic review was unable to judge effectiveness owing to lack of quality evidence. The aim of this pilot study was to gather data on the effect of TENS on phantom pain and stump pain at rest and on movement. Ten individuals with a transtibial amputation and persistent moderate‐to‐severe phantom and/or stump pain were recruited. Inclusion criteria was a baseline pain score of ≥3 using 0 to 10 numerical rating scale (NRS). TENS was applied for 60 minutes to generate a strong but comfortable TENS sensation at the site of stump pain or projected into the site of phantom pain. Outcomes at rest and on movement before and during TENS at 30 minutes and 60 minutes were changes in the intensities of pain, nonpainful phantom sensation, and prosthesis embodiment. Mean (SD) pain intensity scores were reduced by 1.8 (1.6) at rest (P < 0.05) and 3.9 (1.9) on movement (P < 0.05) after 60 minutes of TENS. For five participants, it was possible to project TENS sensation into the phantom limb by placing the electrodes over transected afferent nerves. Nonpainful phantom sensations and prosthesis embodiment remained unchanged. This study has demonstrated that TENS has potential for reducing phantom pain and stump pain at rest and on movement. Projecting TENS sensation into the phantom limb might facilitate perceptual embodiment of prosthetic limbs. The findings support the delivery of a feasibility trial.     

Feasibility Study of Transcutaneous Electrical Nerve Stimulation (TENS) for Cancer Bone Pain

This multicenter study assessed the feasibility of conducting a phase III trial of transcutaneous electrical nerve stimulation (TENS) in patients with cancer bone pain recruited from palliative care services. Eligible patients received active and placebo TENS for 1 hour at site of pain in a randomized crossover design; median interval between applications 3 days. Responses assessed at 30 and 60 minutes included numerical and verbal ratings of pain at rest and on movement, and pain relief. Recruitment, tolerability, adverse events, and effectiveness of blinding were also evaluated. Twenty-four patients were randomised and 19 completed both applications. The intervention was well tolerated. Five patients withdrew: 3 due to deteriorating performance status, and 2 due to increased pain (1 each following active and placebo TENS). Confidence interval estimation around the differences in outcomes between active and placebo TENS suggests that TENS has the potential to decrease pain on movement more than pain on rest. Nine patients did not consider that a placebo was used; the remaining 10 correctly identified placebo TENS. Feasibility studies are important in palliative care prior to undertaking clinical trials. Our findings suggest that further work is required on recruitment strategies and refining the control arm before evaluating TENS in cancer bone pain.PerspectiveCancer bone pain is common and severe, and partly mediated by hyperexcitability. Animal studies suggest that Transcutaneous Electrical Nerve Stimulation can reduce hyperalgesia. This study examined the feasibility of evaluating TENS in patients with cancer bone pain in order to optimize methods before a phase III trial.     

Transcutaneous Electrical Nerve Stimulation Reduces Acute Low Back Pain during Emergency Transport

Background: Patients with acute low back pain may require emergency transport because of pain and immobilization. Transcutaneous electrical nerve stimulation (TENS) is a nonpharmaceutical therapy for patients with low back pain. Objective: To evaluate the efficacy of paramedic‐administered TENS in patients with acute low back pain during emergency transport. Methods: This was a prospective, randomized study involving 74 patients transported to hospital. The patients were randomly assigned to two groups: group 1 (n= 36) was treated with true TENS, while group 2 (n= 36) was treated with sham TENS. The authors recorded pain and anxiety as the main outcome variables using a visual analog scale (VAS). Results: The authors recorded a significant (p < 0.01) pain reduction (mean ± standard deviation) during transport in group 1 (79.2 ± 6.5 mm VAS to 48.9 ± 8.2 mm VAS), whereas pain scores remained unchanged in group 2 (75.9 ± 16.4 mm VAS and 77.1 ± 11.2 mm VAS). Similarly, the scores for anxiety were significantly reduced (p < 0.01) in group 1 (81.7 ± 7.9 mm VAS to 69.2 ± 12.1 mm VAS) after treatment. No significant change was noted (84.5 ± 5.8 mm VAS and 83.5 ± 8.9 mm VAS, respectively) in group 2. Conclusions: TENS was found to be effective and rapid in reducing pain during emergency transport of patients with acute low back pain and should be considered due to its ease of use and lack of side effects in the study population.     

The Effect of Transcutaneous Electrical Nerve Stimulation on Pain During Venous Cannulation

BackgroundThe venous cannulation procedure was widely used in many clinical procedures; however, it is associated with pain or discomfort.ObjectivesThe purpose of this study was to investigate whether transcutaneous electrical nerve stimulation (TENS) could reduce pain during cannulation of vein.MethodsOne hundred patients were allocated randomly to 2 groups. In the active TENS group, TENS was delivered via 2 electrodes on the venous cannulation site (radial side of the wrist of dominant forearm) 20 minutes before venous cannulation, and the control group received placebo (no current) TENS. Venous cannulation with a 22-gauge cannula was performed. During venous cannulation, the pain intensity (0 = no pain, 10 = worst pain imaginable) was measured. Any side effects during study periods were recorded.ResultsThe incidence of pain during venous cannulation was similar between the 2 groups. However, pain intensity was significantly lower in the active TENS group than placebo group (P < 0.01). There was no significant difference in the side effects such as erythema and itching between the groups.ConclusionsTENS may be a suitable option for reducing the pain intensity during venous cannulation. ClinicalTrials.gov identifier: NCT01607463.     

Effect of Transcutaneous Electrical Nerve Stimulation on Postoperative Pain and Patient Satisfaction

Background and AimsThis study was conducted to investigate the effect of transcutaneous electrical nerve stimulation on postoperative pain, changes in patients’ vital signs, and patient satisfaction after inguinal herniorrhaphy.DesignThis study used a randomized controlled design.SettingA state hospital in the west of Turkey.Participants/SubjectsThe study was conducted on 52 patients who had inguinal herniorrhaphy between January and July 2015.MethodsPatients were randomly divided into two groups (intervention and control). Intervention group patients received transcutaneous electrical nerve stimulation postoperatively five times for 30 minutes each. Electrodes in control group patients were placed, but the device was not started. At each transcutaneous electrical nerve stimulation session, the patients’ vital signs and pain severity were recorded. A satisfaction scale was administered before discharge to assess patient satisfaction with nursing care.ResultsPain scores of patients in the intervention group were lower than those in the control group (p < .05). No differences were found in pre–and post–transcutaneous electrical nerve stimulation in the vital signs. Satisfaction scores were higher in the intervention group than control group (p < .05).ConclusionsAfter inguinal herniorrhaphy, transcutaneous electrical nerve stimulation reduced postoperative pain without a negative impact on vital signs and increased patient satisfaction with nursing care.     

糖尿病患者周围神经松解术时骶管阻滞的效果

【目的】观察糖尿病患者周围神经松解术时骶管阻滞的效果。【方法】选择37例需行周围神经松解术的糖尿病患者,在骶管内注入0.5%罗哌卡因25mL行骶管阻滞.记录患者感觉神经、运动神经阻滞起效和维持时间,并观察患者血压、心率变化以及术后不良反应及VAS评分情况。【结果】患者感觉神经和运动神经阻滞起效时间分别为(9.6±2.8)min、(14.6±3.5)min,感觉神经和运动神经阻滞维持时间分别为(222±79)min、(126±49)min。术中所有患者血压、心率平稳,未见术后不良反应发生,术中VAS评分均低于3分。【结论】糖尿病患者周围神经松解术时,应用0.5%罗哌卡因行骶管阻滞,麻醉效果满意,生命体征平稳,毒副作用少,麻醉效果确切。     

The Effect of Transcutaneous Electrical Nerve Stimulation for Pain Relief During Extracorporeal Shock-Wave Lithotripsy Procedure

The purpose of this study was to investigate the effect of transcutaneous electrical nerve stimulation (TENS) for pain relief during extracorporeal shock-wave lithotripsy (ESWL) procedure. An experimental study with repeated measures design was used in this study. Fifty patients aged 20-65 years receiving ESWL treatment were used for this convenience sample. Two applications were used for each patient: one involving administration of TENS instrument for ESWL treatment and the other without TENS. For effective stimulation, 2 stimulator electrodes were placed paravertebrally at L1 and 2 near the lithotripter shock tube before ESWL. Blood pressure, heart rate, pain intensity, analgesic use, and side effects were measured every 10 minutes during the procedure and after the end of ESWL. Results showed that TENS application decreased patients’ intensity of pain and amount of analgesic requests and, related to that, decreased the incidence of side effects and increased patients’ satisfaction during ESWL. TENS application is recommended as a pain-relieving technique during ESWL.     

Efficacy of Transcutaneous Electrical Nerve Stimulation for Osteoarthritis of the Lower Extremities: a Meta-analysis

Abstract

Although transcutaneous electrical nerve stimulation is commonly used to treat the pain of osteoarthritis, the effectiveness of this type of stimulation for pain relief remains controversial. This review found statistically significant results favouring conventional and acupuncture-like stimulation for pain relief and stiffness relief. Mixed stimulation was effective in reducing knee pain but had less effect on hip pain. Burst nerve stimulation resulted in statistically significant relief of knee stiffness and increase in long-term pain relief. Conventional, burst, acupuncturelike, and mixed transcutaneous electrical nerve stimulation have some benefit over placebo for certain aspects of osteoarthritis-associated disability, and can be used as an adjunct therapy for treatment of patients with arthritis involving the hips and/or knees.     

Efficacy of Transcutaneous Electrical Nerve Stimulation (TENS) for Rheumatoid Arthritis: A Systematic Review

Abstract

Transcutaneous electrical nerve stimulation is commonly used to treat the pain of rheumatoid arthritis. The effectiveness of this type of stimulation for pain relief, however, remains controversial. This systematic review was undertaken to determine the efficacy of transcutaneous electrical nerve stimulation in the treatment of rheumatoid arthritis. The review found statistically significant results for pain relief at rest and clinical benefit for muscle power and pain relief at rest for acupuncture-like nerve stimulation compared with placebo. Conventional nerve stimulation showed statistically significant benefit over placebo for tenderness intensity and clinical benefit over acupuncture-like nerve stimulation for patient assessment of disease. The reviewers concluded that both conventional and acupuncture-like transcutaneous electrical nerve stimulation have either statistically or clinically significant benefit over placebo for some aspects of rheumatoid arthritis-associated disability, and can be used as an adjunct therapy for patients with the disease in the treatment of arthritic hands.     

Efficiency of Neuromuscular Electrical Stimulation and Transcutaneous Nerve Stimulation on Hemiplegic Shoulder Pain: A Randomized Controlled Trial

Objective

To compare the efficacy of neuromuscular electrical stimulation (NMES) and transcutaneous nerve stimulation (TENS) on hemiplegic shoulder pain (HSP).

Effects of Transcutaneous Occipital Nerve Stimulation and Instrument-Assisted Soft Tissue Mobilization in Chronic Migraine

ObjectiveThe purpose of this study was to examine the effects of transcutaneous occipital nerve stimulation (TONS) and instrument-assisted soft tissue mobilization (IASTM) on pain, sleep, and quality of life in patients with chronic migraine.MethodsForty-five female patients with chronic migraine were randomly assigned to control (n = 15), IASTM (n = 15), and TONS (n = 15) groups. Neck exercises were given to all groups once per day for 5 weeks. IASTM, using a smooth metal scraping massage tool, was applied to the patients in the IASTM group twice per week for 5 weeks. Patients in the TONS group were treated with transcutaneous electrical nerve stimulation 3 times per week for 5 weeks. The outcome measures were a Numeric Pain Scale, the Headache Impact Test-6, the Pittsburgh Sleep Quality Index, and the Short Form-36.ResultsThe IASTM and TONS groups had significantly lower mean Headache Impact Test-6 scores than the control group in the last measurement (F = 3.908, P = .028). The IASTM and TONS groups had lower mean Numeric Pain Scale scores than the control group (F = 13.861, P = .001). The IASTM group had a lower mean Pittsburgh Sleep Quality Index score in the last measurements than the other 2 groups (F = 6.792, P = .003). There was no difference between the groups in the general health perception scores obtained in the last measurements (F = 1.585, P = .217). In the last measurement, the IASTM and TONS groups had higher mean general health scores than the control group.ConclusionIASTM and TONS applications reduced head and neck pain and improved sleep and quality of life in patients with chronic migraine. Neither had superiority over the other.     

Headache and Cervical Spine Disorders: Classification and Treatment with Transcutaneous Electrical Nerve Stimulation

SYNOPSIS
A clearer definition of the relationship between headache and disorders of the cervical spine appearsnecessary not only for classification purposes but also for a more rational approach to the management ofsuch conditions. The classification proposed here would distinguish headaches etiologically related to cervicalspine disorders from those in which these disorders might represent just one of several triggering orcomplicating factors. The first group includes cervicogenic headache, occipital neuralgia, auriculotemporalneuralgia, cervicalgia and cervicobrachialgia; the second group includes muscle-contraction headache andmixed headache. Treatment with transcutaneous electrical nerve stimulation (TENS) was applied in 10 patientswith cervicogenic headache, 15 patients with occipital neuralgia, and 35 patients with muscle-contraction ormixed headache. Good results, i.e. HI improvement >60% in 70–80% of cases, were obtained in all three groupsof patients, with no significant differences between them.