{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T19:25:38Z","timestamp":1793993138044,"version":"4.8.0"},"reference-count":59,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T00:00:00Z","timestamp":1697068800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_sjpain-2023-0068_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Opioids are important for postoperative analgesia but their use can be associated with numerous side effects. Transcutaneous electrical nerve stimulation (TENS) has been used for acute pain treatment and has dose-dependent analgesic effects, and therefore presents an alternative to intravenous (iv) opioids for postoperative pain relief. The aim of this meta-analysis was to compare high-frequency, high-intensity (HFHI or intense) TENS to iv opioids with regard to postoperative pain intensity, recovery time in the Post Anesthesia Care Unit (PACU) and opioid consumption after elective gynecological surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjpain-2023-0068_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We searched Medline, Embase, Web of Science, Cochrane, Amed and Cinahl for RCTs and quasi-experimental studies (2010\u20132022), and WHO and\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrials.gov\/\">ClinicalTrials.gov<\/jats:ext-link>\n                      for ongoing\/unpublished studies. Meta-analysis and subsequent Trial Sequential Analysis (TSA) was performed for all stated outcomes. Quality of evidence was assessed according to GRADE.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjpain-2023-0068_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Only three RCTs met the inclusion criteria (362 participants). The surgical procedures involved surgical abortion, gynecologic laparoscopy and hysteroscopy. The applied TENS frequency was 80\u202fHz and intensity 40\u201360\u202fmA. There was no difference in pain intensity according to Visual Analogue Scale (VAS) at discharge from PACU between the TENS and opioid group (MD VAS\u00a0\u22120.15, 95\u202f% CI\u00a0\u22120.38 to 0.09) (moderate level of evidence). Time in PACU was significantly shorter in the TENS group (MD\u00a0\u221215.2, 95\u202f%\u00a0\u221222.75 to\u00a0\u22127.67), and this finding was manifested by TSA (high-level of evidence). Opioid consumption in PACU was lower in the TENS group (MD Morphine equivalents per patient mg\u00a0\u22123.42, 95\u202f%\u00a0\u22124.67 to\u00a0\u22122.17) (high-level of evidence).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjpain-2023-0068_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There was no detectable difference in postoperative pain relief between HFHI TENS and iv opioids after gynecological surgery. Moreover, HFHI TENS decreases recovery time and opioid consumption in PACU. HFHI TENS may be considered an opioid-sparing alternative for postoperative pain relief after gynecological surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjpain-2023-0068_abs_005\">\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>PROSPERO CRD42021231048.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/sjpain-2023-0068","type":"journal-article","created":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T05:56:28Z","timestamp":1697003788000},"source":"Crossref","is-referenced-by-count":13,"title":["High-frequency, high-intensity transcutaneous electrical nerve stimulation compared with opioids for pain relief after gynecological surgery: a systematic review and meta-analysis"],"prefix":"10.1515","volume":"24","author":[{"given":"Adam","family":"Piasecki","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care\/Pain Centre , Sahlgrenska University Hospital , Region V\u00e4stra G\u00f6taland , Gothenburg , Sweden"},{"name":"Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences at the Sahlgrenska Academy , University of Gothenburg , Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"\u00d6gren","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences at the Sahlgrenska Academy , University of Gothenburg , Gothenburg , Sweden"},{"name":"Fr\u00f6lunda Specialist Hospital , Region V\u00e4stra G\u00f6taland , Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven-Egron","family":"Th\u00f6rn","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care , Sahlgrenska University Hospital , Region V\u00e4stra G\u00f6taland , Gothenburg , Sweden"},{"name":"Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences at the Sahlgrenska Academy , University of Gothenburg , Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Olausson","sequence":"additional","affiliation":[{"name":"Institute of Health and Care Sciences, Sahlgrenska Academy , University of Gothenburg , Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl Johan","family":"Svensson","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care , Sahlgrenska University Hospital , Region V\u00e4stra G\u00f6taland , Gothenburg , Sweden"},{"name":"Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences at the Sahlgrenska Academy , University of Gothenburg , Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitta","family":"Platon","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care , Sahlgrenska University Hospital , Region V\u00e4stra G\u00f6taland , Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Wolf","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care , Sahlgrenska University Hospital , Region V\u00e4stra G\u00f6taland , Gothenburg , Sweden"},{"name":"Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences at the Sahlgrenska Academy , University of Gothenburg , Gothenburg , Sweden"},{"name":"Faculty of Health Sciences, Department of Nursing and Health Promotion Acute and Critical Illness , Oslo Metropolitan University , Oslo , Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulin","family":"Andr\u00e9ll","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care\/Pain Centre , Sahlgrenska University Hospital , Region V\u00e4stra G\u00f6taland , Gothenburg , Sweden"},{"name":"Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences at the Sahlgrenska Academy , University of Gothenburg , Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2023,10,12]]},"reference":[{"key":"2025120910013783788_j_sjpain-2023-0068_ref_001","doi-asserted-by":"crossref","unstructured":"Benyamin, R, Trescot, AM, Datta, S, Buenaventura, R, Adlaka, R, Sehgal, N, et al.. 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