Transcutaneous electrical nerve stimulation in labour pain: a systematic review

Authors

  • Dawn Carroll,

    Research Sister
    1. Pain Research Unit and Nuffield Department of Anaesthetics, University of Oxford, Oxford Radcliffe Hospital, Headington
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  • Martin Tramèr,

    Visiting Research Fellow
    1. Pain Research Unit and Nuffield Department of Anaesthetics, University of Oxford, Oxford Radcliffe Hospital, Headington
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  • Henry McQuay,

    Clinical Reader (Pain Relief)
    1. Pain Research Unit and Nuffield Department of Anaesthetics, University of Oxford, Oxford Radcliffe Hospital, Headington
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  • Bethany Nye,

    Research Assistant
    1. Pain Research Unit and Nuffield Department of Anaesthetics, University of Oxford, Oxford Radcliffe Hospital, Headington
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  • Andrew Moore

    Consultant (Biochemistry) , Corresponding author
    1. Pain Research Unit and Nuffield Department of Anaesthetics, University of Oxford, Oxford Radcliffe Hospital, Headington
      Correspondence: Dr R. A. Moore, Pain Research Unit, University of Oxford, The Churchill, Oxford Radcliffe Hospital, Headington, Oxford OX3 7LJ, UK.
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Correspondence: Dr R. A. Moore, Pain Research Unit, University of Oxford, The Churchill, Oxford Radcliffe Hospital, Headington, Oxford OX3 7LJ, UK.

Abstract

Objective To review the effectiveness and safety of transcutaneous electrical nerve stimulation (TENS) for labour pain.

Design A systematic review of randomised controlled trials of TENS in pain during labour.

Sample Eight reports involving 712 women were included; 352 women received active TENS and 360 acted as controls.

Methods Reports were sought by searching MEDLINE and the Oxford Pain Relief Database.

Main outcome measures Analgesic and adverse effect outcomes.

Results Evidence for reduced pain using TENS in labour was weak. Additional analgesic interventions may be less likely with TENS (odds ratio 0.57; 95% CI 0.34–0.96), number-needed-to-treat 14 (95% CI 7.3–119).

Conclusions Randomised controlled trials provide no compelling evidence for TENS having any analgesic effect during labour. Weak positive effects in secondary (analgesic sparing) and tertiary (choosing TENS for future labours) outcomes may be due to inadequate blinding causing overestimation of treatment effects.

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