Eletro-neuro-estimulação percutânea PENS/eletroacupuntura) combinada à anestesia local em cirurgia de hérnia inguinal

Abstract

The main objective of this randomized simple-blinded clinical trial was to evaluate the results of percutaneous application of electrical nerve stimulation (PENS) over pain (transoperative, postoperative, immediate and delayed) and other clinical and laboratorial aspects in patients submitted to inguinal hernia surgery. The control group was submitted to false transcutaneous electrical nerve stimulation (TENS sham). Methods: PENS was applied with varied frequencies along time, before the beginning and during the surgery, with needles inserted over peri-incisional region and situated next to peripheral nervous branches, and in the ear pavillion temporarily implanted. All patients received routine local sedation and anesthesia. Measures of outcome: hemodynamic parameters, doses of sedatives and analgesics used in the operative time, immediate and delayed levels of post-perative pain (measured in Visual Analogical Scale and by analgesics requirement), the extension of the peri-incisional edema, leukometria and perioperative blood glucose. Results: 1. the real intervention did not permit reduction of analgesics need during the surgery; 2. Greater pain intensity of the control group (n=17) in relation to treatment group (n=16) was verified, on the 4th and 7th postoperative days; greater consumption of analgesics on the 4th and 6th days; higher glucose blood levels in the immediate postoperative and occurrence of peri-incisional seroma (5/17x 0/16). Conclusions: PENS utility for pain during the surgery was not demonstrated. Stabilization of blood glucose levels and lower pain intensity in the postoperative period observed on treatment group can both be attributed to the supraspinal effects of PENS, while its local and segmental effects should have avoid the occurrence of peri-incisional seroma.