Transcutaneous electrical nerve stimulation eases pain after inguinal hernia repair

Incorporating transcutaneous electrical nerve stimulation (TENS) into a multimodal intervention safely and effectively alleviates postoperative pain and analgesic use following open inguinal hernia repair, a recent trial has found.

Eighty men scheduled for elective primary unilateral hernia Lichtenstein repair were enrolled and randomly assigned to a treatment regimen with TENS or with a placebo counterpart (n=40 each). In both arms, participants were also provided with postoperative pharmacological analgesics and kinesiotherapy. TENS was delivered on the first two postoperative days, and the primary outcome of change in pain intensity was measured after every TENS session.

TENS seemed to provide temporary pain relief in participants. Visual analogue scale (VAS) pain scores significantly dropped after TENS (p<0.001) before subsequently rising, reaching a minor peak prior to the second TENS session within the same day.

Nevertheless, the cumulative absolute and relative relief was significantly better in the TENS group than in placebo controls in terms of pain at rest (p<0.01), while walking (p<0.01), and when standing up from the bed (p<0.01).

Moreover, the mean additional analgesic dose required was significantly higher in the placebo group both on postoperative days 1 (p=0.03) and 2 (p<0.001), as well as overall (p<0.001). Neither arm required opioid or semiopioid analgesics.

“TENS can contribute to the reduction of postoperative analgesics consumption,” the researchers said. “We suggest that TENS could be used in daily practice as part of a multimodal postoperative pain treatment plan following open inguinal hernia repair, especially for patients suffering from hyperalgesia.”