• Yu-Wen Chen, Jann-Inn Tzeng, Min-Fei Lin, Ching-Hsia Hung, Pei-Ling Hsieh, and Jhi-Joung Wang.
• From the *Department of Physical Therapy, China Medical University, Taichung; †Department of Medical Research, Chi-Mei Medical Center; ‡Department of Food Sciences and Technology, Chia Nan University of Pharmacy and Science, Jen-Te; §Department of Anesthesiology, Chi-Mei Medical Center, Yong Kang; and ∥Institute and Department of Physical Therapy, National Cheng Kung University, Tainan City, Taiwan.
• Reg Anesth Pain Med. 2014 Jul 1;39(4):322-8.

BackgroundTranscutaneous electrical nerve stimulation (TENS) is a common therapeutic modality for pain management, but its effectiveness in skin/muscle incision and retraction (SMIR)-evoked pain is unknown. We aimed to examine the effects of TENS on postoperative pain and the levels of substance P (SP), N-methyl-D-aspartate receptor 1 (NR1), and interleukin 1β (IL-1β) in rat dorsal root ganglion (DRG).MethodsHigh-frequency (100 Hz) TENS was administered daily beginning on postoperative day 1 (POD1) and continued until animal subjects were killed for tissues. Mechanical sensitivity to von Frey stimuli (6g and 15g) and the levels of NR1, SP, and IL-1β in DRG were assessed in the sham-operated, SMIR-operated, TENS after SMIR surgery, and placebo-TENS after SMIR surgery groups.ResultsSkin/muscle incision and retraction rats exhibited a significant hypersensitivity to von Frey stimuli on POD3. In contrast with SMIR rats, SMIR-operated rats receiving TENS therapy demonstrated a rapid recovery of mechanical hypersensitivity. The SMIR-operated rats showed an up-regulation of NR1, SP, and IL-1β in DRG on PODs 14 and 28, whereas the SMIR-operated rats after TENS administration reversed this up-regulation. By contrast, the placebo-TENS after SMIR operation did not alter postsurgical pain nor the levels of NR1, SP, and IL-1β.ConclusionsOur data demonstrated that TENS intervention reduced persistent postoperative pain caused by SMIR operation. Up-regulation of NR1, SP, and IL-1β in DRG, activated after SMIR surgery, is important in the development of prolonged postincisional pain. The TENS pain relief may be related to the suppression of NR1, SP, and IL-1β in DRG of SMIR rats.

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