Evaluation of the Effect of Transcutaneous Electrical Nerve Stimulation on Postoperative Pain in Surgical Extraction of Impacted Mandibular Third Molars: A Double Blind Randomized Clinical Trial

Hamidreza Arabion, Hamid Kazemi, Yaser Dehganian, Reyhaneh Ebrahimi, Reza Tabrizi



Introduction: Transcutaneous electrical nerve stimulation (TENS) has been used to reduce post-operative pain. The aim of this study was to assess the efficacy of TENS as an adjunctive pain relief measure after impacted third molar surgery. Materials and Methods: In this double-blind randomized clinical trial, patients requiring surgical extraction of third molars (Class 2 and B of Pell and Gregory) were randomly divided into two groups. Group I subjects received TENS immediately after surgery along with analgesics (400 mg Gelofen). In group II, patients received 400 mg Gelofen immediately post-operation (control group). The pain intensity was evaluated using a visual analog scale (VAS) eight hours after surgery. The independent t-test was applied to compare pain intensity between the two groups. Results: Three-hundred subjects were studied in two groups (each group had 150 participants). The mean pain intensity score was 3.7±1.43 in group I and 4.36±1.66 in group II. A significant difference was noted for pain intensity between the two groups (P=0.001). Conclusion: Use of TENS may decrease pain intensity during the first eight hours after impacted third molar surgery and may obviate the need for additional doses of non-steroidal anti-inflammatory drugs (NSAIDs).


Tooth extraction; Pain; Transcutaneous electric nerve stimulation

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Facci LM, Nowotny JP, Tormem F, Trevisani VFM. Effects of transcutaneous electrical nerve stimulation (TENS) and interferential currents (IFC) in patients with nonspecific chronic low back pain: randomized clinical trial. Sao Paulo Med J. 2011;129(4):206-16.

Simpson PM, Fouche PF, Thomas RE, Bendall JC. Transcutaneous electrical nerve stimulation for relieving acute pain in the prehospital setting: a systematic review and meta-analysis of randomized-controlled trials. Eur J Emerg Med. 2014;21(1):10-7.

Johnson MI, Mulvey MR, Bagnall AM. Transcutaneous electrical nerve stimulation (TENS) for phantom pain and stump pain following amputation in adults. Cochrane Database Syst Rev. 2015(8).

Hurlow A, Bennett MI, Robb KA, Johnson MI, Simpson KH, Oxberry SG. Transcutaneous electric nerve stimulation (TENS) for cancer pain in adults. Cochrane Database Syst Rev. 2012.

Walsh DM, Howe TE, Johnson MI, Moran F, Sluka KA. Transcutaneous electrical nerve stimulation for acute pain. The Cochrane Library. 2009.

Melzack R, Casey KL. Sensory, motivational, and central control determinants of pain. The skin senses1968. p. 423-39.

Vera‐Portocarrero LP, Cordero T, Billstrom T, Swearingen K, Wacnik PW, Johanek LM. Differential effects of subcutaneous electrical stimulation (SQS) and transcutaneous electrical nerve stimulation (TENS) in rodent models of chronic neuropathic or inflammatory pain. Neuromodulation. 2013;16(4):328-35.

Tyler E, Caldwell C, Ghia JN. Transcutaneous electrical nerve stimulation: an alternative approach to the management of postoperative pain. Anesth Analg. 1982;61(5):449-56.

Olaogun MO, Parkins G, Addo E, Avogo D, Appiah-Kubi K. Comparative Effects of Transcutaneous Electrical Nerve Stimulation, Cryotherapy and Placebo on Pain, Swelling and Trismus Following Third Molar Tooth Extraction. Nigerian J Med Rehabilitation. 2012;15(1 and 2):38-43.

Olaogun M, Fagade O, Akinloye A, Omojowolo O. Effects of Transcutaneous Electrical Nerve Stimulation on pain, swelling and trismus following third molar tooth extraction. Nigerian J Health Sci. 2001;1(1):18-22.

Melzack R, Wall PD. Pain mechanisms: a new theory. Survey of Anesthesiology. 1967;11(2):89-90.

Johnson M. Transcutaneous electrical nerve stimulation: mechanisms, clinical application and evidence. 2007.

Sluka KA, Walsh D. Transcutaneous electrical nerve stimulation: basic science mechanisms and clinical effectiveness. J Pain. 2003;4(3):109-21.

Tashani O, Johnson M. Transcutaneous Electrical Nerve Stimulation (TENS). A Possible Aid for Pain Relief in Developing Countries? Libyan J Med. 2009;4(2).

Wynn R. Update on nonprescription pain relievers for dental pain. General Dent. 2004;52(2):94.

Johnson MI, Paley CA, Howe TE, Sluka KA. Transcutaneous electrical nerve stimulation for acute pain. Cochrane Database Syst Rev. 2015;6:Cd006142.

Walsh DM, Howe TE, Johnson MI, Sluka KA. Transcutaneous electrical nerve stimulation for acute pain. Cochrane Database Syst Rev. 2009(2):Cd006142.

Tavares MG, Machado AP, Motta BG, Borsatto MC, Rosa AL, Xavier SP. Electro-acupuncture efficacy on pain control after mandibular third molar surgery. Braz Dent J. 2007;18(2):158-62.

Fagade O, Obilade T. Therapeutic effect of TENS on post-IMF trismus and pain. Afr J Med Med Sci. 2003;32(4):391-4.

Schafer E, Finkensiep H, Kaup M. Effect of transcutaneous electrical nerve stimulation on pain perception threshold of human teeth: a double-blind, placebo-controlled study. Clin Oral Investig. 2000;4(2):81-6.

Roth PM, Thrash WJ. Effect of transcutaneous electrical nerve stimulation for controlling pain associated with orthodontic tooth movement. Am J Orthod Dentofacial Orthop. 1986;90(2):132-8.

Santana LS, Gallo RB, Ferreira CH, Duarte G, Quintana SM, Marcolin AC. Transcutaneous electrical nerve stimulation (TENS) reduces pain and postpones the need for pharmacological analgesia during labour: a randomised trial. J Physiother. 2015.

Peng T, Li XT, Zhou SF, Xiong Y, Kang Y, Cheng HD. Transcutaneous electrical nerve stimulation on acupoints relieves labor pain: a non-randomized controlled study. Chin J Integr Med. 2010;16(3):234-8.

DOI: https://doi.org/10.22037/rrr.v2i1.14201


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