• Pauline Binder, Annica Gustafsson, Kerstin Uvnäs-Moberg, and Eva Nissen.
• Department of Women's and Children's Health, IMCH, Akademiska Hospital/Uppsala University, Drottninggatan 4, 4th Floor, SE-75185 Uppsala, Sweden.pauline.binder@kbh.uu.se
• Midwifery. 2011 Aug 1; 27 (4): 547-52.

Objectivesto examine effectiveness and overall opiate consumption between high-sensory transcutaneous electrical nerve stimulation (Hi-TENS) combined with patient-controlled analgesia with morphine and patient-controlled analgesia with morphine alone following elective (e.g. scheduled) caesarean birth.Designrandomised, controlled study.Settinga county hospital in south-west Sweden.Participants42 multiparous women.Measurements And Findingsparticipants were randomly assigned and connected to patient-controlled analgesia with morphine alone or in combination with Hi-TENS apparatus. Levels of morphine consumed were calculated every third hour during the first 24 hours post partum. Pain and sedation were assessed by visual analogue scale at one, three, six, nine, 12 and 24 hours post partum. Total consumption of morphine differed significantly between the groups: morphine with TENS was 16.2 ± 12.6 mg and morphine alone was 33.1 ± 20.9 mg (p = 0.007). Assessment of pain relief showed no significant difference. Sedation differed significantly between the groups (p = 0.045), especially between three and 12 hours post partum (p = 0.011).Key Conclusions And Implications For Practicepain relief from a combination of Hi-TENS and patient-controlled analgesia with morphine was as effective as patient-controlled analgesia with morphine alone, produced less sedation and reduced morphine use by approximately 50%. Women undergoing a caesarean section should be given the opportunity to make an informed choice about post operative pain relief before surgery. A presumed benefit of this treatment combination is that the mother is more alert and better able to interact with her newborn during the first hours after birth without drowsiness due to large doses of opiates.Copyright © 2010 Elsevier Ltd. All rights reserved.

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