Iranian Red Crescent Medical Journal

Published by: Kowsar

Preemptive Analgesic Effects of Transcutaneous Electrical Nerve Stimulation (TENS) on Postoperative Pain: A Randomized, Double-Blind, Placebo-Controlled Trial

Mohammad Eidy 1 , Mohammad Reza Fazel 2 , Monir Janzamini 1 , * , Mostafa Haji Rezaei 2 and Ali Reza Moravveji 2
Authors Information
1 Department of General Surgery, Kashan University of Medical Sciences, Kashan, IR Iran
2 Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
Article information
  • Iranian Red Crescent Medical Journal: April 01, 2016, 18 (4); e35050
  • Published Online: April 12, 2016
  • Article Type: Research Article
  • Received: November 27, 2015
  • Revised: January 29, 2016
  • Accepted: February 21, 2016
  • DOI: 10.5812/ircmj.35050

To Cite: Eidy M, Fazel M R, Janzamini M, Haji Rezaei M, Moravveji A R. Preemptive Analgesic Effects of Transcutaneous Electrical Nerve Stimulation (TENS) on Postoperative Pain: A Randomized, Double-Blind, Placebo-Controlled Trial, Iran Red Crescent Med J. 2016 ; 18(4):e35050. doi: 10.5812/ircmj.35050.

Copyright © 2016, Iranian Red Crescent Medical Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Objectives
3. Patients and Methods
4. Results
5. Discussion
  • 1. Beadles CA, Meagher AD, Charles AG. Trends in emergent hernia repair in the United States. JAMA Surg. 2015; 150(3): 194-200[DOI][PubMed]
  • 2. Keller JJ, Muo CH, Lan YC, Sung FC, Lo FE, Chiang KY, et al. A nation-wide population-based study of inguinal hernia repair incidence and age-stratified recurrence in an Asian population. Hernia. 2015; 19(5): 735-40[DOI][PubMed]
  • 3. Pukar M, Lakhani D. Combination of liechtenstein repair with herniorrhaphy in open inguinal hernia repair- a prospective observational single center study. J Clin Diagn Res. 2014; 8(10)-8[DOI][PubMed]
  • 4. Dalamagka M, Mavrommatis C, Grosomanidis V, Karakoulas K, Vasilakos D. Postoperative analgesia after low-frequency electroacupuncture as adjunctive treatment in inguinal hernia surgery with abdominal wall mesh reconstruction. Acupunct Med. 2015; 33(5): 360-7[DOI][PubMed]
  • 5. Parsons B, Schaefer C, Mann R, Sadosky A, Daniel S, Nalamachu S, et al. Economic and humanistic burden of post-trauma and post-surgical neuropathic pain among adults in the United States. J Pain Res. 2013; 6: 459-69[DOI][PubMed]
  • 6. Lu J, Liu Z, Xia K, Shao C, Guo S, Wang S, et al. Effect of preemptive analgesia with parecoxib sodium in patients undergoing radical resection of lung cancer. Int J Clin Exp Med. 2015; 8(8): 14115-8[PubMed]
  • 7. Rosero EB, Joshi GP. Preemptive, preventive, multimodal analgesia: what do they really mean? Plast Reconstr Surg. 2014; 134(4 Suppl 2): 85S-93S[DOI][PubMed]
  • 8. Taghavi R, Tabasi KT, Mogharabian N, Asadpour A, Golchian A, Mohamadi S, et al. The effect of acupuncture on relieving pain after inguinal surgeries. Korean J Pain. 2013; 26(1): 46-50[DOI][PubMed]
  • 9. Coura LE, Manoel CH, Poffo R, Bedin A, Westphal GA. Randomised, controlled study of preoperative electroacupuncture for postoperative pain control after cardiac surgery. Acupunct Med. 2011; 29(1): 16-20[DOI][PubMed]
  • 10. Li G, Li S, Sun L, Lin F, Wang B. A comparison study of immune-inflammatory response in electroacupuncture and transcutaneous electrical nerve stimulation for patients undergoing supratentorial craniotomy. Int J Clin Exp Med. 2015; 8(2): 2662-7[PubMed]
  • 11. Kasat V, Gupta A, Ladda R, Kathariya M, Saluja H, Farooqui AA. Transcutaneous electric nerve stimulation (TENS) in dentistry- A review. J Clin Exp Dent. 2014; 6(5)-8[DOI][PubMed]
  • 12. Shanavas M, Chatra L, Shenai P, Rao PK, Jagathish V, Kumar SP, et al. Transcutaneous electrical nerve stimulation therapy: An adjuvant pain controlling modality in TMD patients - A clinical study. Dent Res J (Isfahan). 2014; 11(6): 676-9[PubMed]
  • 13. DeSantana JM, Santana-Filho VJ, Guerra DR, Sluka KA, Gurgel RQ, da Silva WM. Jr.. Hypoalgesic effect of the transcutaneous electrical nerve stimulation following inguinal herniorrhaphy: a randomized, controlled trial. J Pain. 2008; 9(7): 623-9[DOI][PubMed]
  • 14. Scott J, Huskisson EC. Graphic representation of pain. Pain. 1976; 2(2): 175-84[PubMed]
  • 15. Wang B, Tang J, White PF, Naruse R, Sloninsky A, Kariger R, et al. Effect of the intensity of transcutaneous acupoint electrical stimulation on the postoperative analgesic requirement. Anesth Analg. 1997; 85(2): 406-13[PubMed]
  • 16. Johnson MI, Paley CA, Howe TE, Sluka KA. Transcutaneous electrical nerve stimulation for acute pain. Cochrane Database Syst Rev. 2015; 6[DOI][PubMed]
  • 17. Dias M, Carneiro NM, Guerra LA, Velarde GC, de Souza PA, da Silva LL, et al. Effects of electroacupuncture on local anaesthesia for inguinal hernia repair: a randomised placebo-controlled trial. Acupunct Med. 2010; 28(2): 65-70[DOI][PubMed]
  • 18. Zhang SP, Chiu TT, Chiu SN. Long-term efficacy of electroacupuncture for chronic neck pain: a randomised controlled trial. Hong Kong Med J. 2013; 19 Suppl 9: 36-9[PubMed]
  • 19. Khadilkar A, Odebiyi DO, Brosseau L, Wells GA. Transcutaneous electrical nerve stimulation (TENS) versus placebo for chronic low-back pain. Cochrane Database Syst Rev. 2008; (4)[DOI][PubMed]
  • 20. Meng FG, Zhang JG, Schoenen J, Vandersmissen B, Herroelen L, Vandenheede M, et al. Migraine prevention with a supraorbital transcutaneous stimulator: a randomized controlled trial. Neurology. 2013; 81(12): 1102[DOI][PubMed]
  • 21. Pivec R, Minshall ME, Mistry JB, Chughtai M, Elmallah RK, Mont MA. Decreased Opioid Utilization and Cost at One Year in Chronic Low Back Pain Patients Treated with Transcutaneous Electric Nerve Stimulation (TENS). Surg Technol Int. 2015; 27: 268-74[PubMed]
  • 22. Plastaras CT, Schran S, Kim N, Sorosky S, Darr D, Chen MS, et al. Complementary and alternative treatment for neck pain: chiropractic, acupuncture, TENS, massage, yoga, Tai Chi, and Feldenkrais. Phys Med Rehabil Clin N Am. 2011; 22(3): 521-37[DOI][PubMed]
  • 23. Santana LS, Gallo RB, Ferreira CH, Duarte G, Quintana SM, Marcolin AC. Transcutaneous electrical nerve stimulation (TENS) reduces pain and postpones the need for pharmacological analgesia during labour: a randomised trial. J Physiother. 2016; 62(1): 29-34[DOI][PubMed]
  • 24. Moayedi M, Davis KD. Theories of pain: from specificity to gate control. J Neurophysiol. 2013; 109(1): 5-12[DOI][PubMed]
  • 25. Kerai S, Saxena KN, Taneja B, Sehrawat L. Role of transcutaneous electrical nerve stimulation in post-operative analgesia. Indian J Anaesth. 2014; 58(4): 388-93[DOI][PubMed]
  • 26. Campbell JN, Taub A. Local analgesia from percutaneous electrical stimulation. A peripheral mechanism. Arch Neurol. 1973; 28(5): 347-50[PubMed]
  • 27. Janko M, Trontelj JV. Transcutaneous electrical nerve stimulation: a microneurographic and perceptual study. Pain. 1980; 9(2): 219-30[PubMed]
  • 28. Ren W, Tu W, Jiang S, Cheng R, Du Y. Electroacupuncture improves neuropathic pain: Adenosine, adenosine 5'-triphosphate disodium and their receptors perhaps change simultaneously. Neural Regen Res. 2012; 7(33): 2618-23[DOI][PubMed]
  • 29. Sawynok J. Adenosine receptor targets for pain. Neuroscience. 2015; [DOI][PubMed]
  • 30. Lima LV, Cruz KM, Abner TS, Mota CM, Agripino ME, Santana-Filho VJ, et al. Associating high intensity and modulated frequency of TENS delays analgesic tolerance in rats. Eur J Pain. 2015; 19(3): 369-76[DOI][PubMed]
  • 31. Xiang XH, Chen YM, Zhang JM, Tian JH, Han JS, Cui CL. Low- and high-frequency transcutaneous electrical acupoint stimulation induces different effects on cerebral mu-opioid receptor availability in rhesus monkeys. J Neurosci Res. 2014; 92(5): 555-63[DOI][PubMed]
  • 32. Pitangui AC, Araujo RC, Bezerra MJ, Ribeiro CO, Nakano AM. Low and high-frequency TENS in post-episiotomy pain relief: a randomized, double-blind clinical trial. Braz J Phys Ther. 2014; 18(1): 72-8[PubMed]
  • 33. Dietis N, Rowbotham DJ, Lambert DG. Opioid receptor subtypes: fact or artifact? Br J Anaesth. 2011; 107(1): 8-18[DOI][PubMed]
  • 34. Escobar W, Ramirez K, Avila C, Limongi R, Vanegas H, Vazquez E. Metamizol, a non-opioid analgesic, acts via endocannabinoids in the PAG-RVM axis during inflammation in rats. Eur J Pain. 2012; 16(5): 676-89[DOI][PubMed]
  • 35. Cipriano G. Jr., Neder JA, Umpierre D, Arena R, Vieira PJ, Chiappa AM, et al. Sympathetic ganglion transcutaneous electrical nerve stimulation after coronary artery bypass graft surgery improves femoral blood flow and exercise tolerance. J Appl Physiol (1985). 2014; 117(6): 633-8[DOI][PubMed]
  • 36. Han JS, Chen XH, Sun SL, Xu XJ, Yuan Y, Yan SC, et al. Effect of low- and high-frequency TENS on Met-enkephalin-Arg-Phe and dynorphin A immunoreactivity in human lumbar CSF. Pain. 1991; 47(3): 295-8[PubMed]
  • 37. Leonard G, Goffaux P, Marchand S. Deciphering the role of endogenous opioids in high-frequency TENS using low and high doses of naloxone. Pain. 2010; 151(1): 215-9[DOI][PubMed]
  • 38. Bhat ZF, Kumar S, Bhat HF. Bioactive peptides of animal origin: a review. J Food Sci Technol. 2015; 52(9): 5377-92[DOI][PubMed]
  • 39. Guzzo LS, Romero TR, Queiroz-Junior CM, Caliari MV, Azevedo AO, Perez AC, et al. Involvement of endogenous opioid peptides in the peripheral antinociceptive effect induced by the coffee specific diterpene kahweol. Pharmacol Rep. 2015; 67(5): 1010-5[DOI][PubMed]
Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .

Search Relations:



Create Citiation Alert
via Google Reader

Readers' Comments