HI-TENS reduces moderate-to-severe pain associated with most wound care procedures: A pilot study

Abstract

This study systematically examined pain associated with wound care procedures (WCPs) and evaluated the effectiveness of high-intensity transcutaneous electrical nerve stimulation (HI-TENS) for reducing this pain in a two-phase design. Phase 1 (N = 57) examined patient, wound, and procedural factors, as well as analgesic intake, associated withWCPs. Pain during the WCPs was rated on a 0-10 numerical scale. Subjects reported a mean pain of 6.0 (standard deviation 3.04) during Phase 1, with 43 (75.4%) subjects experiencing moderate or severe pain (i.e., ≥ 4). Subjects who received opioid and/or nonopioid analgesia 1 hr before or during theWCPs (36.8%) reported significantly higher pain levels than those who had not received analgesia (p =.013). In Phase 2, 23 subjects with ≥ 4 pain during Phase 1 had HI-TENS applied to the area surrounding the wound during the WCPs. HI-TENS significantly reduced WCP pain by a mean of 2.0 (±2.31; effect size = 0.67; p =.001). This effect was significant for subjects with severe Phase 1 pain (i.e., ≥ 8; effect size = 1.00; p =.007) but not for subjects with moderate Phase 1 pain (i.e., 4-7; effect size= 0.40; p =.053). These findings demonstrate that pain duringWCPs is a significant problem, that nurses appropriately administer analgesics but these are not sufficient, and that using HI-TENS may further reduce pain, particularly in patients experiencing severe WCP pain. © The Author(s) 2013.