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Tens settings for labour?

Is there any evidence to recommend which style of tens application is more beneficial during labour? As in acupuncture like tens or pain gate theory? Many thanks

Bridget Bazell

2 months ago

Back to General Electrotherapy

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Fiona Rogers
Fiona Rogers

The pre-set program in the commonly used NeuroTrac Obstetric TENS uses 90Hz with a boost mode of bursts at 150Hz in bursts of 9 ie this is during the contraction once the boost plunger is pressed, at the end of contraction the woman presses the plunger again and it drops back to the rest mode of 90Hz it works very effectively for many women

Prof James Bellew
Prof James Bellew

Bridget, Dong et al, Arch Gynecol Obstet, 2015 used 100Hz (high frequency gate control) at the starting point of active labor in an RCT of 180 patients. Significant analgesic effects were noted during active labor. Shaban, Evid Based Women Health J, 2013, also an RCT N=100, used TENS and allowed the patients to use "high frequency TENS" or "burst" mode TENS. In the TENS group there was less need for oxytocin despite non-significant differences in pain scores between the TENS and control group. I am not aware of any study that specifically compared acupuncture like TENS (low frequency) to gate (high frequency) TENS.

Prof Gad Alon
Prof Gad Alon

My limited knowledge in the area of providing electrical stimulation DURING LABOUR is that what matter is not the frequency as much as the stimulation intensity that should be high enough to mask the labour pain (regardless of the theories of pain modulation) and that the electrodes should move distally (toward the sacrum) as the labour progresses. This can be done using two channels, one over the lumbar and one over the sacral area. If the stimulation cause more pain to the woman than the labour pain or is does not decrease the labour pain, it is obviously not helping and must be stopped.

Cliff Eaton
Cliff Eaton

Dear Bridget We tend to recommend TENS for chronic pain. The lower Hz encourages the release of endorphins into our system and clinically I find this works well for more acute pain. Chattanooga on their NMES units recommend a mixture of both for lumbago and I would advocate this type of application. You could for example start with Low frequency at the onset of pain and then move to TENS settings for the rest of the day Cliff

Cliff Eaton
Cliff Eaton

Dear Bridget We tend to recommend TENS for chronic pain. The lower Hz encourages the release of endorphins into our system and clinically I find this works well for more acute pain. Chattanooga on their NMES units recommend a mixture of both for lumbago and I would advocate this type of application. You could for example start with Low frequency at the onset of pain and then move to TENS settings for the rest of the day Cliff

bridget382
bridget382

Thanks Cliff, it was more whether it is better to keep as pain gate settings (good point 're modulation) or whether acupuncture like settings of lower Hz longer wave length may be more beneficial?

Cliff Eaton
Cliff Eaton

Dear Bridget TENS alters our pain perception by what is hypothesised as the 'Pain Gate Theory' Frequencies betwe of between 80 and 150Hz have been shown to provide this outcome. Machines in general will provide choices of frequency. *0Hz and 100Hz being typical. The pain relief effect lasts while the machine is on. If used for ong periods of the day, such as during pregnancy, your nervous system can 'accommodate' to it. To avoid this it is useful to use a TENS unit that has modulating frequencies. Those that constantly change so the nervous system cannot accommodate as it does for a single frequency I hope that is useful Cliff

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