Effectiveness of Intramuscular Electrical Stimulation on Postsurgical Nociceptive Pain for Patients Undergoing Open Pancreaticoduodenectomy: A Randomized Clinical Trial.

Background After pylorus-preserving pancreaticoduodenectomy (PPPD), incision and suture of the abdominal muscles cause inflammatory changes and elicit somatic pain that deteriorates the quality of life. There have been no previous reports on needle electrical twitch obtaining intramuscular stimulation (NETOIMS) in abdominal open surgery; thus, this study aimed to apply NETOIMS for postoperative somatic pain in patients undergoing PPPD as a new treatment modality for pain control. Methods Between June 2018 and January 2019, 44 patients who underwent PPPD were randomly assigned to the control group and NETOIMS group. The NETOIMS group received NETOIMS in the transverse abdominis muscle under ultrasound guidance right after surgery under general anesthesia. The pain score (visual analog scale, VAS), peak cough flow (PCF), and gait speed were repetitively measured from a day before surgery to 2 weeks after discharge as scheduled. Data were analyzed by the linear mixed model and repeated measures analysis of variance. Results Of the 44 patients recruited, data of 38 patients were finally analyzed. The pain scores were significantly lower in the NETOIMS group after PPPD (P = 0.01). Although the PCF at each measuring time point did not show inter-group difference (P = 0.20), improvement of PCF from the second day of surgery to discharge was greater (P = 0.02) and gait speed improved significantly faster (P Conclusions The NETOIMS helps in rapid reduction of postoperative somatic pain developed after PPPD and in improvement of PCF and gait speed.