Effect of transcutaneous electrical nerve stimulation for pain relief on patients undergoing hemorrhoidectomy - Prospective, randomized, controlled trial

PURPOSE: Posthemorrhoidectomy pain control remains a challenging problem. Transcutaneous electrical nerve stimulation is known to be effective in the treatment of many diseases. Our aim was to investigate the effect of transcutaneous electrical nerve stimulation on pain relief in patients undergoing hemorrhoidectomy. METHODS: Sixty patients with symptomatic hemorrhoids were randomly allocated into two groups, the acupoint group (n = 30) and the nonpoint control group (n = 30). Transcutaneous electrical nerve stimulation was applied to those patients who received hemorrhoidectomy and patient-controlled analgesia was achieved by injection of morphine through ambulatory infusion pumps. The dependent measures in this study were pain score from 0 (no pain) to 10 (agonizing pain), analgesic doses administrated through patient-controlled analgesia, and postoperative complications. RESULTS: The subjective pain scores evaluated 8, 12, 16, and 24 hours after hemorrhoidectomy in the control group and the acupoint group were 5.9 +/- 0.5 and 4.1 +/- 0.5, 5.7 +/- 0.5 and 3.5 +/- 0.4, 4.1 +/- 0.4 and 2.3 +/- 0.3, and 3.2 +/- 0.4 and 1.9 +/- 0.2, respectively (two-way: analysis of variance; P < 0.05). There was a significant difference bem een treatment groups in morphine use, with 11.6 +/- 2.2 mg in the control group and 6.2 +/- 1.3 mg in the acupoint group (P ( 0.05). The acupoint group tended to have less postoperative acute urinary retention (Fisher's exact probability test; P = 0.145) and less need for analgesics than the control group (P = 0.112, Fisher's exact test). CONCLUSION: Transcutaneous electrical nerve stimulation is effective for pain relief in patients receiving hemorrhoidectomy. Its efficacy and safety could assist outpatient pain management after hem orrhoidectomy.