Transcutaneous Electric Nerve Stimulation (TENS) for pain relief during Extracorporeal Shock-Wave Lithotripsy (ESWL)

Abstract

Background: Anesthesia for ESWL must provide good analgesia, rapid recovery with least side effects. Opioids are commonly used analgesics during ESWL, but are not devoid of side effects. TENS is a non-pharmacological, non-invasive analgesic technique, which has been recommended for pain control in many clinical settings. Methods: Sixty patients scheduled for ESWL were randomly assigned to group-A (30 patients): received IV fentanyl 1µg/Kg with the application of conventional TENS. Group-B (30 patients) received IV fentanyl 1µg/Kg. IV increments of 20 µg of fentanyl were given if VAS was≥3 in both groups. Fentanyl consumption, discharge time, adverse effects, and satisfaction score for patients were compared. Results: VAS was lower among group-A than group-B throughout the procedure but that was statistically non-significant. There was significantly lower fentanyl consumption in group-A compared to group-B (P-value < 0.001). Discharge time was significantly shorter among group-A (36.2 ± 0.6 min) than group-B (47.2 ± 0.8 min). Adverse effects were significantly less frequent in group-A compared to group-B. Incidences of O2 desaturation, nausea and vomiting were higher in group-B compared to group-A. Patients’ satisfaction was significantly higher among group-A than among group-B. Conclusion: TENS is an effective and safe practice in controlling pain during ESWL, it decreases fentanyl consumption and its side effects, with greater patients’ satisfaction. It decreases discharged time compared to fentanyl so it is ideal for outpatient procedures.