The clinical effectiveness of transcutaneous electrical nerve stimulation on enhancing recovery after cesarean section: A systematic review and meta-analysis

Background: The transcutaneous electrical nerve stimulation TENS was used following several surgical procedures involving gynecological ones and has shown a successful pain reduction rate. TENS was proposed to enhance recovery after cesarean section CS. Objective: This systematic review and meta-analysis were conducted to evaluate the clinical effectiveness of Transcutaneous electrical nerve stimulation TENS in enhancing recovery after a cesarean section. Methods: We performed the Meta-analyses using RevMan software. Data were pooled as mean difference (MD) if continuous and risk ratio (RR) if dichotomous, and the 95% confidence interval (CI) as calculated. Results: This systematic review included 12 RCTs, with a total of 1,116 women studied. The TENS effectively reduced the intensity of pain just by following its application (SMD=-0.61; 95% CI [-0.82, -0.39], P<0.00001), one day after (SMD=-0.25; 95% CI [-0.47, -0.04], P=0.02), and two days after (SMD=-0.27; 95% CI [-0.50, -0.03], P=0.03). Conclusion: The TENS effectively reduces the pain intensity following its application and after one or two days. TENS has no effect on the cumulative dose of diclofenac. Because of the inadequacy of safety data, we recommend conducting further RCTs.