Intrapartum Transcutaneous Electrical Nerve Stimulation for Pain Relief and Outcome of Labour

Abstract

Objective: Transcutaneous electrical nerve stimulation (TENS) has been introduced as an option for the relief of labour pain in our hospital, but its efficacy and impact on labour outcome remains uncertain. A nonblinded study was therefore performed to address these issues.
Methods: This study was conducted over a 5-month period by purposive sampling of all the women who had requested TENS for pain relief during the early phase of labour and in the absence of significant complications or contraindications. Maternal demographics, pain scores as assessed by a validated pain assessment form, and labour outcomes were analysed according to the types of pain relief method used in the form of: TENS with or without entonox (TENS group); TENS and pethidine injection (pethidine group); and TENS with epidural analgesia (epidural group).
Results: In the final study, 265 women (18% of labouring women within the study period) completed the assessment forms. TENS alone was sufficient for pain relief in 38% of these women, and 87% achieved spontaneous delivery compared with the other groups altogether (p = 0.004; adjusted odds ratio = 3.21; 95% confidence interval, 1.44-7.15). The duration of first stage (p = 0.046) and second stage (p < 0.001) were the shortest in the TENS group.
Conclusion: The result of this survey showed that TENS alone with or without the addition of entonox was sufficient for pain relief in 38% of the women. Furthermore, the use of TENS was associated with the shortest first and second stages of labour, and highest rate of spontaneous delivery. The role and merits of TENS for pain relief in uncomplicated labour should be explored further.