Cumulative morphine requirementVisual analog scale(VAS)
Auxiliary Medication
One hour prior to surgery diazepam 0.15 mg/kg was given orally and atropine 0.6 mg intramuscularly. Routine induction with thiopentone, suxamethonium and intubation was followed by fluothane 0.5% and nitrous oxide-oxygen anaesthesia in all cases. During the operation only a short acting opiate, fentanyl 50 ug, was given intravenously as deemed necessary by the anaesthetist. Subsequently, patients were prescribed 0.15 mg/kg of morphine and 10 mg metoclopramide intramuscularly 4 hourly on demand.
Stimulation Method
TEAS
Induction Method
Electroacupuncture Instrument Model
Manufacturer
Frequency
Waveform
Strength
Induction Time
Neuromod 3722
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-
-
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Acupuncture_Needle
Needle_Manufacturer
Needle_Depth
-
-
-
Description The TES group experienced sensory stimulation from electrodes (Medtronic 3791) coated with electrode gel (Spectra 360) attached for demonstration purposes to the right subcostal margin. They were told to maintain a strong tingling sensation by adjusting the intensity and frequency of the stimulation as required. Patients in the PL group were treated similarly except they were told not to expect any particular sensation.
Anesthesia Method
AAA
Clinical Trial Type
random
Contraindications
Patients with a history of malignant disease organic brain damage, major psychological disturbance and known analgesic oralcoholic abuse were excluded
Effector
M48 was significantly correlated with the VAS score (r 0.62, P<0.001), and with the psychometric test scores for trait-anxiety (r= 0.70, P<0.001) and neuroticism (r0.67, P<0.001). Though patients treated with TES required 25% less morphine than those treated with placebo, the difference was not significant using monovariate analysis and applying unpaired two-tailed Student's t-test (P> 0.2). When the contribution of neuroticism to the variance of M48 was adjusted using multiple regression analysis, the effect of TES became significant at the 0.05 level. Covariance analysis showed that TES contributed some 19% to the explained variance of M48 while neuroticism contributed about 80%, and there was no interaction between these two factors.
Postoperative pain control: contribution of psychological factors and transcutaneous electrical stimulation.
Abstract
The influence of transcutaneous electrical stimulation (TES) and psychological factors in determining the intensity of acute postoperative pain was examined in a prospective, double-blind controlled trial completed by 30 patients having elective surgery. Psychometric tests were administered prior to surgery. Postoperative pain was assessed by cumulative morphine requirement (M48) administered intramuscularly, and the mean score of a visual analogue scale of pain (VAS), in the first 48 h following surgery. M48 was significantly correlated with the VAS score (r = 0.62, P less than 0.001), and with the psychometric test scores for trait-anxiety (r = 0.70, P less than 0.001) and neuroticism (r = 0.67, P less than 0.001). Though patients treated with TES required 25% less morphine than those treated with placebo, the difference was not significant using monovariate analysis and applying unpaired two-tailed Student's t-test (P less than 0.2). When the contribution of neuroticism to the variance of M48 was adjusted using multiple regression analysis, the effect of TES became significant at the 0.05 level. Covariance analysis showed that TES contributed some 19% to the explained variance of M48 while neuroticism contributed about 80%, and there was no interaction between these two factors. These findings allow a degree of prediction of the individual patient's postoperative pain and narcotic requirement, and point to a strong correlation between postoperative pain perception and personality."
