Is transcutaneous electrical nerve stimulator useful for analgesia during delivery

The way of nerve system electric stimulation analgesia (TENS) comes from the basic theory of hydraulic gate operation clearly put forward by Melzack in 1965. What should we pay attention to during delivery? What should I do in the third trimester? Is transcutaneous electrical nerve stimulator useful for analgesia during delivery? He believes that the dorsal cord of spinal cord has a water gate like mechanism. Stimulating A-and C chemical fibers can “open” the water gate to the outside world, so that desire can be transmitted and promoted to the nerve center through neurotransmitters; Stimulation of crude A-B chemical fibers can “close” the water gate and inhibit synaptic transmission. Therefore, the stimulation effect of jugular nervous system can stimulate the coarse sympathetic nerve and inhibit the ascending transmission of pain.

Is transcutaneous electrical nerve stimulator useful for analgesia during delivery

In the early 1970s, electrodes were immediately placed around the spinal cord of patients with diffuse pain. When the transcutaneous electrical stimulation test was used before placing the electrode, it was found that the effect of electrical stimulation without surgical intervention was more prominent. Since then, the transcutaneous electrical stimulation instrument of nervous system has become a standard way to relieve pain in many tongtongmen clinics. At this stage, the only contraindication of tens is patients with pacemaker. TENS was first used for labor analgesia in Germany, and it attracted further scientific research. What should we pay attention to during childbirth? What should I do in the third trimester? Is transcutaneous electrical nerve stimulator useful for analgesia during delivery? 0 yuan collar professional emotion analysis! 10s quick appointment >

Tens is used for labor analgesia. The electrode is placed on the afferent nerve transmitted by the dorsal sensory nerve, that is, the approach of the dorsal cord of the spinal cord. During the first stage of labor, a pair of electrodes were placed on the back T10 ~ L. On both sides of the spinal cord channel (breast), another pair of electrodes were placed at the second stage of labor S。 Both sides of the spinal canal (sacral).

The electric stimulator must release 4 ~ 150Hz bipolar biphasic waveform single pulse according to the requirements, and the compressive strength is 0 ~ 55mA. During labor analgesia, the strongly recommended frequency is 40 ~ 80Hz, and the compressive strength is adjusted according to the uterine contraction of the patient; This is due to the level of uterine contraction pain of the pregnant woman and her tolerance to the tingling sensation of the electric stimulator. Generally, the compressive strength should be 25 ~ 40mA during uterine contraction; The uterine contraction interval should be 5 ~ 10 meters a. The disadvantage of this method is that electrical stimulation (especially in the sacral electrode) will affect the detection of fetal heart rate.

The efficiency of TENS for labor analgesia is about 40%. It will need to rely on other drugs (such as pethidine) to improve the actual analgesic effect. The application of tens has the best analgesic effect on back pain during uterine contraction, while the analgesic effect on phalangeal bone and vulva is the worst. The analgesic effect of the first stage of labor is better than that of the second stage of labor. On the one hand, tens efficacy can not imply the harm of efficacy; On the other hand, the electrode part also endangers the actual effect of analgesia.

Is transcutaneous electrical nerve stimulator useful for analgesia during delivery? Tens is a key way to relieve labor pain of pregnant women according to the harm of social psychology, improve the pain threshold, and show a meaningful physical analgesic effect that can not be quantified and analyzed. Tens has obvious implied efficacy. No matter whether tens electrode is properly placed or not, there is no difference in patient satisfaction rate. The quantitative analysis of tens in labor analgesia seems very difficult, but it can reduce the need for full use of drugs during labor. Tens is more reasonable in the first stage of labor than in the second stage of labor (the second stage of labor generally requires private nerve block). Fens has no negative effect. The only defect is that it can affect the detection of fetal heart rate and prohibit the use in patients with pacemaker (rare for pregnant women). When tens analgesia is not complete, it is necessary to add analgesics or regional obstruction.