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Hi-TENS combined with PCA-morphine as post caesarean pain relief.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Internationell kvinno- och mödrahälsovård och migration/Essén)
Department of Woman and Child Health/Division of Reproductive and Perinatal Health Care, Karolinska Institute, Stockholm, Sweden.
Swedish University of Agriculture, Skara, Sweden.
Department of Woman and Child Health/Division of Reproductive and Perinatal Health Care, Karolinska Institute, Stockholm, Sweden.
2011 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 27, no 4, 547-552 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: to examine effectiveness and overall opiate consumption between high-sensory transcutaneous electrical nerve stimulation (Hi-TENS) combined with patient-controlled analgesia with morphine and patient-controlled analgesia with morphine alone following elective (e.g. scheduled) caesarean birth. DESIGN: randomised, controlled study. SETTING: a county hospital in south-west Sweden. PARTICIPANTS: 42 multiparous women. MEASUREMENTS AND FINDINGS: participants were randomly assigned and connected to patient-controlled analgesia with morphine alone or in combination with Hi-TENS apparatus. Levels of morphine consumed were calculated every third hour during the first 24 hours post partum. Pain and sedation were assessed by visual analogue scale at one, three, six, nine, 12 and 24 hours post partum. Total consumption of morphine differed significantly between the groups: morphine with TENS was 16.2±12.6mg and morphine alone was 33.1±20.9mg (p=0.007). Assessment of pain relief showed no significant difference. Sedation differed significantly between the groups (p=0.045), especially between three and 12 hours post partum (p=0.011). KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: pain relief from a combination of Hi-TENS and patient-controlled analgesia with morphine was as effective as patient-controlled analgesia with morphine alone, produced less sedation and reduced morphine use by approximately 50%. Women undergoing a caesarean section should be given the opportunity to make an informed choice about post operative pain relief before surgery. A presumed benefit of this treatment combination is that the mother is more alert and better able to interact with her newborn during the first hours after birth without drowsiness due to large doses of opiates.

Place, publisher, year, edition, pages
2011. Vol. 27, no 4, 547-552 p.
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Public Health, Global Health, Social Medicine and Epidemiology
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URN: urn:nbn:se:uu:diva-153201DOI: 10.1016/j.midw.2010.05.002ISI: 000292912300024PubMedID: 20615594OAI: oai:DiVA.org:uu-153201DiVA: diva2:415516
Available from: 2011-05-06 Created: 2011-05-06 Last updated: 2017-12-11Bibliographically approved

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