AAOS2017: TENS demonstrates analgesic potential following outpatient arthroscopic RCR

Study Type: Randomized Trial
OE Level of Evidence: N/A
Journal Level of Evidence: N/A
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Synopsis
37 patients scheduled for arthroscopic rotator cuff repair were randomized to either an active or sham transcutaneous electrical nerve stimulation (TENS) device to be used for the first week postoperatively to determine its effect on postoperative pain. Patients were assessed for pain using a visual analog scale, and for the number of opioid analgesia pills taken (Percocet) over the first week after surgery. Results demonstrated significantly Please login to view the rest of this report. Please login to view the rest of this report.
Why was this study needed now?
Pain after rotator cuff repair can be considerable. Many multimodal analgesic regimens have been described, often featuring opioid analgesics. However, there has been an emphasis towards moving away from opioid analgesics to manage pain due to concerns of opioid abuse. Transcutaneous electrical nerve stimulation has been explored as a possible modality for analgesia and has previously demonstrated early positive results in cases of post-total knee arthroplasty. Therefore, its use as an analgesic modality in arthroscopic rotator cuff repair needed to be tested.
What was the principal research question?
Following outpatient arthroscopic rotator cuff repair, does the use of transcutaneous electrical nerve stimulation (TENS) significantly reduce pain scores and opioid analgesia use within the first week after surgery when compared to sham-TENS?
Population: 37 patients with a full-thickness rotator cuff tear and scheduled for arthroscopic repair. Opioids analgesia was prescribed to all patients to manage postoperative breakthrough pain.
Intervention: TENS group: Patients were instructed to use the provided TENS device for 45-minute sessions, four times each day.
Comparison: Sham group: Patients were instructed to use the provided sham-TENS device for 45-minute sessions, four times each day.
Outcomes: Postoperative outcomes included pain on a visual analog scale (VAS), and the number of analgesic pills taken.
Methods: RCT
Time: Results reported for 48 hours postoperatively, and 1 week postoperatively.
What were the important findings?
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How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.