Pain Management with Electrical Stimulation
According to Behren's, Pain management involves controlling the perception and/or sensation of pain.
- actively involves patient to control discomfort
- analgesic effect on central and peripheral nervous system
- block pain by stimulating
Transcutaneus Electrical Nerve Stimulation (TENS)
Application of electrical stimulation across the skin; portable units capable of stimulating nerve receptors and block ascending nerve pathways to gait pain reception
Analgesia vs Anesthesia
Analgesia is the absence of pain or noxious stimulation; the absence of sensibility to pain; or the relief of pain without a loss of consciousness
Anesthesia is a loss of sensation, usually by damage to a nerve or receptor, that is numbness; or the loss of ability to feel pain caused by the administration of drugs or medical interventions.
- Sensory analgesia can produce a "tingling" with activation of A-beta nerve fibers causing a "gating" mechanism at the level of the spinal cord preventing pain from traveling higher, relief usually only occurs while stimulus is being applied.
- Endogenous opiate release may occur with stimulation of A-delta and C-fibers with electrodes over motor points to reach level, mimicking narcotic drugs and decreasing perception of pain; if electrical stimulation can produce the same effect, it can be supplemented for narcotics
- Alcohol also produced analgesia through depression of the central nervous system and should be avoided while electrica stimulation is applied
- Excercise beyond tolerance can produce sharp A-beta pain; electrical stimulation during exercise may be utilized to combat this
Contraindications
- Demand type cardiac pacemakers
- Over carotid sinus
- Directly over the eye
- Epilepsy
- Malignancy
- Loss or decrease in sensation
Precautions
- Monitor patients with known cardia disease or arrhythmia
- Directly over an open wound
- Lumbar region of pregnany person, except during lab pains possibly
- Diagnoses malignancies as terminal, palliative pain relief with informed consent
- External use only, keep out of reach of children