Obstetrical analgesia Archives - Revista Brasileira de Ginecologia e Obstetrícia

PURPOSE: to determine maternal and neonatal outcome according to the application or not of transcutaneous electrical nerve stimulation (TENS) for relief of labor pain before installation of combined spinal epidural (CSE) block. METHODS: a randomized open clinical trial was conducted involving 22 parturients with a singleton, vertex, term fetus, managed in a tertiary-care academic medical center in Recife, Brazil. These patients were randomly assigned to receive or not TENS before CSE block for labor analgesia. Outcome analysis included pain intensity as measured by visual analog scale (VAS), interval between initial evaluation and CSE installation, labor duration, cesarian section and instrumental delivery rate, Apgar scores and frequency of neonatal hypoxia. Statistical analysis was performed using Mann-Whitney and Fisher's exact tests with a 5% level of significance. RESULTS: a significantly prolonged interval between initial evaluation and CSE block was observed in the TENS group (median of 90 min) when compared with the control group (median of 30 min). Duration of labor was similar (about 6 h). No significant difference was found in VAS scores. Cesarian section rate was 18.2% in both groups. There was only one forceps delivery (in the control group). The median of Apgar scores at the 5th minute was 10 and no case of neonatal hypoxia was found. CONCLUSONS: TENS was effective in delaying CSE analgesia installation without affecting pain intensity and duration of labor. There were no adverse effects on mothers or newborns.