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The efficacy of pulsed electromagnetic field therapy for management of postoperative pain following cesarean section: a randomized, double-blind, placebo-controlled study
Abstract Number: S-1
Abstract Type: Original Research
Background: Pulsed electromagnetic field (PEMF) therapy has been used in various clinical settings, especially after plastic surgery, to reduce postoperative edema and pain as well as to accelerate wound repair (1). PEMF devices induce a very low frequency electromagnetic field into the body tissues which modify calcium/calmodulin-dependent nitric oxide cascades to reduce inflammation and improve healing (2). PEMF therapy is simple to use, cost-effective and has no known side effects. This study was designed to assess if the continuous use of a PEMF device for 48 hours post cesarean section (CS) would result in decreased postoperative pain scores on movement at 48 hours.
Methods: With REB Approval and informed consent, we conducted this randomized, double blind, placebo-controlled trial. Women ≥ 18 years old with term singleton pregnancies undergoing elective CS under spinal anesthesia were invited to participate. Spinal anesthesia included fentanyl 10mcg and morphine 100 mcg, and postoperative analgesia regimen included standing orders of diclofenac and acetaminophen, plus PRN systemic morphine. Patients were randomly allocated into one of two groups: active or inactive PEMF devices. The PEMF device (active or inactive loop) was applied over the incision area (over the dressing while dressing in place) immediately after surgery and used continuously for 48 hours. The following data were collected: maternal demographics, obstetrical data, surgical data, pain scores (VAS 0-100 mm) at rest and on movement, maternal satisfaction (VAS 0-100 mm) and morphine consumption at 24 and 48 hours following surgery.
Results: We included 125 patients (57 active, 68 inactive). There were no significant differences in maternal characteristics, obstetrical and surgical data. Pain scores, patient satisfaction with analgesia, and opioid consumption were similar at 24 and 48 hours (Table 1).
Conclusion: This study demonstrates that, in the context of a multimodal analgesia regimen inclusive of intrathecal opioids (fentanyl and morphine), the use of PEMF therapy for a short-period of time post cesarean section does not further improve pain management and patient satisfaction. Further evaluation of PEMF therapy is warranted in CS as part of analgesia regimens not inclusive of intrathecal opioids, where pain management may be less optimal.
References: 1) Strauch B et al. Aesthetic Surg J 2009; 29:135–143; 2) Guo L et al. Electromag Biol Med 2011;30: 21–45