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An Evaluation of Transcutaneous Electrical Nerve Stimulation for Pain Relief in Labour
Author(s) -
Thomas I. L.,
Tyle V.,
Webster J.,
Neilson A.
Publication year - 1988
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1988.tb01660.x
Subject(s) - transcutaneous electrical nerve stimulation , medicine , pain relief , visual analogue scale , physical therapy , anesthesia , alternative medicine , pathology
EDITORIAL COMMENT: It is undeniable that fashion determines details of management in obstetric practice e.g. techniques of antenatal preparation, place of birth, position at birth. Methods of pain relief in labour have also varied, but in recent years the trend has been towards an increased use of epidural analgesia on the one hand, and a wish to avoid conventional methods of analgesia altogether on the other! It is against this background that transcutaneous electrical nerve stimulation (TENS) has been introduced into labour wards in many hospitals. This careful, large study tackles the difficult task of critical appraisal of patients' perception of pain in labour and its influence by TENS. The authors have shown that although the method does no harm, it probably does little good and they do not advocate its widespread introduction for routine use in labour. Summary: The effectiveness of transcutaneous nerve stimulation (TENS) for pain relief in labour was evaluated by randomizing 280 patients in early labour into 2 groups. Inoperative sham machines were applied to patients in the control group and active units to those in the test group. Neither patients nor attending labour ward staff were aware of which group the patient was in. The intensity of low back pain and abdominal pain was assessed by the patient each hour on a visual analogue pain scale. Each patient served as her own control by switching off the machine for 2 contractions every hour and then recording the intensity of pain. The amount of conventional analgesia each patient received was recorded by labour ward staff. There was no difference in the intensity of pain recorded by each group. Nor was there any difference between the 2 groups in the change of pain experienced when the machine was switched off. Moreover there was no difference in the amount of other analgesia required. Some differences were found when those with little low back pain were excluded from the study. We conclude that TENS is ineffective as a routine method of pain relief in labour. It is likely to benefit only those with severe back pain and then only to a modest degree.