Effectiveness of Intramuscular Electrical Stimulation on Postsurgical Nociceptive Pain for Patients Undergoing Open Pancreaticoduodenectomy: A Randomized Clinical Trial

Jinyoung Park; Hyung Sun Kim; Jung Hyun Park; Yoon Ghil Park; Sanghoon Shin; Jae Eun Park; Sangwon Hwang; So Young Jun; Joon Seong Park

doi:10.1016/j.jamcollsurg.2020.06.008

Effectiveness of Intramuscular Electrical Stimulation on Postsurgical Nociceptive Pain for Patients Undergoing Open Pancreaticoduodenectomy: A Randomized Clinical Trial

J Am Coll Surg. 2020 Sep;231(3):339-350. doi: 10.1016/j.jamcollsurg.2020.06.008. Epub 2020 Jul 2.

Authors

Jinyoung Park¹, Hyung Sun Kim², Jung Hyun Park¹, Yoon Ghil Park¹, Sanghoon Shin³, Jae Eun Park³, Sangwon Hwang³, So Young Jun², Joon Seong Park⁴

Affiliations

¹ Rehabilitation Institute of Neuromuscular Disease, Department of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
² Pancreatobiliary Cancer Clinic, Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
³ Gangnam Severance Hospital, Department Rehabilitation Medicine, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
⁴ Pancreatobiliary Cancer Clinic, Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: jspark330@yuhs.ac.

PMID: 32623088
DOI: 10.1016/j.jamcollsurg.2020.06.008

Abstract

Background: After pylorus-preserving pancreaticoduodenectomy (PPPD), incision and suture of the abdominal muscles cause inflammatory changes and elicit somatic pain that deteriorates the quality of life. There have been no previous reports on needle electrical twitch obtaining intramuscular stimulation (NETOIMS) in abdominal open operation; this study aimed to apply NETOIMS for postoperative somatic pain in patients undergoing PPPD as a new treatment modality for pain control.

Methods: Between June 2018 and January 2019, 44 patients who underwent PPPD were randomly assigned to a control group and the NETOIMS group. The NETOIMS group received NETOIMS in the transverse abdominis muscle under ultrasound guidance right after operation under general anesthesia. The pain score (visual analog scale), peak cough flow (PCF), and gait speed were repetitively measured from 1 day before operation to 2 weeks after discharge as scheduled. Data were analyzed by the linear mixed model and repeated-measures analysis of variance.

Results: Of the 44 patients recruited, data from 38 patients were finally analyzed. The pain scores were significantly lower in the NETOIMS group after PPPD (p = 0.01). Although the PCF at each measuring time point did not show inter-group difference (p = 0.20), improvement of PCF from the second day after operation to discharge was greater (p = 0.02) and gait speed improved significantly faster (p < 0.01) in the NETOIMS group than in the control group.

Conclusions: NETOIMS helps in rapid reduction of postoperative somatic pain developed after PPPD and in improvement of PCF and gait speed.

Trial registration: ClinicalTrials.gov NCT03619343.

Publication types

Randomized Controlled Trial

MeSH terms

Aged
Double-Blind Method
Electric Stimulation Therapy / methods*
Female
Humans
Male
Middle Aged
Nociceptive Pain / etiology*
Nociceptive Pain / therapy*
Pain, Postoperative / etiology*
Pain, Postoperative / therapy*
Pancreaticoduodenectomy / adverse effects*

Associated data

ClinicalTrials.gov/NCT03619343