Transcutaneous Electric Nerve Stimulation for Analgesia During Outpatient Endometrial Biopsy: A Randomized Controlled Trial.

IF 5.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Obstetrics and gynecology Pub Date : 2025-01-01 Epub Date: 2024-11-21 DOI:10.1097/AOG.0000000000005727

Jenny Wu, Stephanie Lim, Amelia Scott, Taylor Hayes, Shakthi Unnithan, Alaattin Erkanli, Laura J Havrilesky, Jonas J Swartz

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引用次数: 0

Abstract

Objective: To evaluate whether transcutaneous electric nerve stimulation (TENS) decreases pain at the time of outpatient endometrial biopsy.

Methods: We conducted a randomized, double-blind trial of active TENS compared with placebo TENS at the time of endometrial biopsy. The primary outcome was pain measured on a 0- to 100-mm visual analog scale immediately after biopsy, with secondary outcomes including satisfaction and tolerability of TENS and pain scores at other procedural time points. To detect a 15-mm reduction in pain with a 30-mm SD, 80.0% power, and a significance level of 0.05, 64 participants were required in each arm.

Results: From December 2022 to December 2023, 135 participants were randomized with 67 in the placebo TENS arm and 68 in the active TENS arm. Baseline demographic and clinical characteristics were similar between groups. The median (interquartile range) pain score immediately after biopsy was 50 mm (20-80 mm) in the active TENS group and 60 mm (40-100 mm) in the placebo TENS group ( P =.039). Pain scores at other time intervals were not statistically significantly different. In a subset analysis, participants with higher-than-median baseline anxiety had postprocedural pain scores (interquartile range) of 50 mm (40-80 mm) in the active TENS group compared with 80 mm (50-100 mm) in the placebo TENS group. Overall satisfaction (interquartile range) with pain control (with 100 mm representing completely satisfied) was 87.5 mm (60-100 mm) for active TENS and 70 mm (41-100 mm) for placebo TENS; 85.3% of active TENS participants would use TENS in a future endometrial biopsy. Minimal side effects were associated with TENS, with one participant reporting itching at the pad sites.

Conclusion: Despite a statistical difference in pain scores, a clinical difference was not seen between active and placebo TENS for pain during endometrial biopsy. Satisfaction was higher in the active TENS group, and there were overall minimal side effects associated with TENS.

Clinical trial registration: ClinicalTrials.gov , NCT05472740.

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门诊子宫内膜活检期间经皮神经电刺激镇痛：随机对照试验。

目的：评估经皮神经电刺激（TENS）能否减轻门诊子宫内膜活检时的疼痛：评估经皮神经电刺激（TENS）是否能减轻门诊子宫内膜活检时的疼痛：我们进行了一项随机双盲试验，将子宫内膜活检时的主动 TENS 与安慰剂 TENS 进行比较。主要结果是活检后立即用 0 至 100 毫米视觉模拟量表测量疼痛，次要结果包括对 TENS 的满意度和耐受性以及其他手术时间点的疼痛评分。每组需要64名参与者，才能检测到疼痛减轻15毫米，SD值为30毫米，功率为80.0%，显著性水平为0.05：从 2022 年 12 月到 2023 年 12 月，135 名参与者接受了随机治疗，其中安慰剂 TENS 治疗组 67 人，活性 TENS 治疗组 68 人。两组的基线人口统计学和临床特征相似。活检后立即疼痛评分的中位数（四分位间距）为：主动 TENS 组 50 mm（20-80 mm），安慰剂 TENS 组 60 mm（40-100 mm）（P=0.039）。其他时间间隔的疼痛评分没有显著统计学差异。在一项子集分析中，基线焦虑高于中位数的参与者在主动 TENS 组的术后疼痛评分（四分位间范围）为 50 毫米（40-80 毫米），而安慰剂 TENS 组为 80 毫米（50-100 毫米）。主动 TENS 组对疼痛控制的总体满意度（四分位数间距）（100 mm 代表完全满意）为 87.5 mm（60-100 mm），安慰剂 TENS 组为 70 mm（41-100 mm）；85.3% 的主动 TENS 参与者会在今后的子宫内膜活检中使用 TENS。TENS的副作用极小，仅有一名参与者报告垫子部位瘙痒：结论：尽管在疼痛评分上存在统计学差异，但在子宫内膜活检过程中，主动和安慰剂TENS疗法对疼痛的治疗效果并无临床差异。活性 TENS 组的满意度更高，TENS 的副作用总体上很小：临床试验注册：ClinicalTrials.gov，NCT05472740。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obstetrics and gynecology 医学-妇产科学

CiteScore

11.10

自引率

4.20%

发文量

867

审稿时长

1 months

期刊介绍： "Obstetrics & Gynecology," affectionately known as "The Green Journal," is the official publication of the American College of Obstetricians and Gynecologists (ACOG). Since its inception in 1953, the journal has been dedicated to advancing the clinical practice of obstetrics and gynecology, as well as related fields. The journal's mission is to promote excellence in these areas by publishing a diverse range of articles that cover translational and clinical topics. "Obstetrics & Gynecology" provides a platform for the dissemination of evidence-based research, clinical guidelines, and expert opinions that are essential for the continuous improvement of women's health care. The journal's content is designed to inform and educate obstetricians, gynecologists, and other healthcare professionals, ensuring that they stay abreast of the latest developments and best practices in their field.