TENS for pain management of Aspiration Abortion up to 83 day
Expanding pain management options can improve the quality of and access to abortion. Transcutaneous electrical nerve stimulation could be a standalone or adjunct approach for abortion pain management for those without access to or are ineligible to receive IV sedation due to the lack of sedation practitioner, designated driver, or local restrictions.

The objective was to evaluate high-frequency, high-intensity transcutaneous electrical nerve stimulation (TENS) as an inexpensive, non-invasive pain management approach for first-trimester aspiration abortion.

Researchers conducted a noninferiority, single-blind, randomized controlled trial of patients seeking aspiration abortion at up to 83 days of gestation. Participants received TENS or IV sedation (fentanyl, midazolam). The primary outcome was pain with aspiration, as self-reported by visual analog scale (VAS, 100 mm).

Investigators enrolled 109 participants. Participant median gestation was 53 days in the TENS group and 58 days in the IV group.

- The intention-to-treat analysis yielded noninferior results for the primary outcome. In the per-protocol analysis, 9 in the TENS group were excluded after receiving IV sedation; 100 participants were included.

- Median reported VAS for aspiration was 73 mm and 66 mm in the TENS and IV groups, respectively.

- With a mean difference of 4.4 mm, they found TENS to be noninferior to IV. Physicians underestimated participant pain, perceiving pain to be 34 mm in the TENS group and 25 mm in the IV group.

In particular, researchers found TENS to be a noninferior alternative to IV sedation for aspiration pain during the first-trimester abortion.

Obstetrics & Gynecology
Source: https://journals.lww.com/greenjournal/Abstract/9900/Transcutaneous_Electrical_Nerve_Stimulation_for.261.aspx