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Transcutaneous electrical nerve stimulation in labour pain: a systematic review
D Carroll1, M Tramèr, H McQuay
1Pain Research Unit, University of Oxford, Oxford Radcliffe Hospital, Headington, UK.
British Journal of Obstetrics and Gynaecology
|February 1, 1997
Summary
Transcutaneous electrical nerve stimulation (TENS) shows weak evidence for reducing labor pain. While TENS may decrease the need for other analgesics, compelling evidence for its effectiveness is lacking.
Area of Science:
- Obstetrics and Gynecology
- Pain Management
- Neurology
Background:
- Labor pain is a significant concern for birthing individuals.
- Non-pharmacological pain relief methods are sought to complement or replace traditional analgesics.
- Transcutaneous electrical nerve stimulation (TENS) is a non-invasive modality explored for pain management.
Purpose of the Study:
- To systematically review the effectiveness and safety of transcutaneous electrical nerve stimulation (TENS) for managing pain during labor.
- To evaluate the analgesic and adverse effect outcomes associated with TENS use in laboring women.
Main Methods:
- A systematic review of randomized controlled trials (RCTs) was conducted.
- Searches were performed in MEDLINE and the Oxford Pain Relief Database.
- Eight reports involving 712 women (352 active TENS, 360 controls) were analyzed for analgesic and adverse effects.
Main Results:
- Evidence supporting TENS for reducing labor pain was found to be weak.
- Women receiving TENS were less likely to require additional analgesic interventions (OR 0.57; 95% CI 0.34-0.96).
- The number-needed-to-treat for avoiding additional analgesia was calculated as 14 (95% CI 7.3-119).
Conclusions:
- Randomized controlled trials do not provide compelling evidence for TENS having a significant analgesic effect during labor.
- Potential weak positive effects in secondary outcomes (analgesic sparing) may be influenced by inadequate blinding, potentially overestimating treatment effects.
- Further research with robust blinding is needed to definitively assess TENS efficacy in labor pain.