Kurata NB, Ghatnekar RJ, Mercer E, Chin JM, Kaneshiro B, Yamasato KS. Transcutaneous electrical nerve stimulation for post–cesarean delivery pain control: a randomized controlled trial. Obstet Gynecol 2022;139.
The authors provided this information as a supplement to their article.
©2022 American College of Obstetricians and Gynecologists. Page 1 of 5
1. In the last 24 hours, what was the worst your pain has been on a scale from 0-10 (0= no pain, 10= worst pain ever)?
2. What is current level of pain on a scale of 0-10 (0= no pain, 10= worst pain ever)?
3. How satisfied are you with your pain management (0= not satisfied, 5= neutral, 10= very satisfied)?
4. If patient has a TENS unit device:
a. Are you using TENS unit?
b. Have you experienced any side effects with the TENS unit? If so, what?
**Phone calls will be made 3 times: at 24- and 48-hours post-op as well as on POD#3 (if still admitted)
Kurata NB, Ghatnekar RJ, Mercer E, Chin JM, Kaneshiro B, Yamasato KS. Transcutaneous electrical nerve stimulation for post–cesarean delivery pain control: a randomized controlled trial. Obstet Gynecol 2022;139.
The authors provided this information as a supplement to their article.
©2022 American College of Obstetricians and Gynecologists. Page 2 of 5
Appendix 2. Opioid consumption up to 60 hours postoperatively in morphine milligram equivalents (MME) in active and placebo transcutaneous electrical nerve stimulation (TENS) groups. The box represents the interquartile range (IQR) containing the middle 50% of cases, the horizontal line within the box represents the median with the numerical value noted above the line, the whiskers are lines that extend from the upper edge of the box to the highest values <1.5 times the IQR, the data points beyond the whiskers represent outliers (between 1.5 and 3 times the IQR), asterisk represents extreme outliers (more than 3 times the IQR).
Kruskal Wallis test, P=.31.
Kurata NB, Ghatnekar RJ, Mercer E, Chin JM, Kaneshiro B, Yamasato KS. Transcutaneous electrical nerve stimulation for post–cesarean delivery pain control: a randomized controlled trial. Obstet Gynecol 2022;139.
The authors provided this information as a supplement to their article.
©2022 American College of Obstetricians and Gynecologists. Page 3 of 5
Active TENS Placebo TENS P
Excluding no intrathecal opioids 57 (95%) 59 (98%)
Morphine milligram equivalents 7.5 [0-30.0] 0 [0-22.5] 0.46
No opioids used 26 (46%) 32 (54%) 0.46
Maximum pain score in past 24 hours
Postoperative Day 1 n= 57 n= 58
5.0 (3.5) 4.0 (3.0) 0.45
Postoperative Day 2 n= 47 n= 49
6.0 (4.0) 5.0 (2.5) 0.41
Postoperative Day 3 n= 23 n= 31
6.0 (2.0) 5.0 (2.0) 0.18
Excluding sterilization 58 (97%) 60 (100%)
Morphine milligram equivalents 7.5 [0-31.9] 0 [0-22.5] 0.97
No opioids used 26 (45%) 32 (53%) 0.37
Maximum pain score in past 24 hours
Postoperative Day 1 n= 58 n= 59
5.0 (4.0) 4.0 (3.0) 0.49
Postoperative Day 2 n= 48 n= 50
6.0 (4.0) 5.0 (3.0) 0.56
Postoperative Day 3 n= 25 n= 32
6.0 (4.0) 5.5 (2.0) 0.39
Per-protocol analysis† 32 (53%) 40 (67%)
Morphine milligram equivalents 15 [0-43.1] 7.5 [0-30.0] 0.90
No opioids used 10 (31%) 17 (43%) 0.46
Maximum pain score in past 24 hours
Postoperative Day 1 n= 32 n= 40
5.0 (4.8) 5.0 (3.0) 0.42
Postoperative Day 2 n= 32 n= 39
6.0 (3.0) 5.0 (3.0) 0.56
Postoperative Day 3 n= 22 n= 31
6.0 (2.0) 5.0 (2.0) 0.16
TENS, transcutaneous electrical nerve stimulation.
Data are median [interquartile range] or n (%) unless otherwise specified.
* Pain score based on 11-point Likert scale (0 = no pain, 10 = worst pain imaginable)
† Per-protocol analysis- excluding patients who did not receive intrathecal opioids, underwent sterilization, or who were discharged prior to 60 hours postoperatively
Kurata NB, Ghatnekar RJ, Mercer E, Chin JM, Kaneshiro B, Yamasato KS. Transcutaneous electrical nerve stimulation for post–cesarean delivery pain control: a randomized controlled trial. Obstet Gynecol 2022;139.
The authors provided this information as a supplement to their article.
©2022 American College of Obstetricians and Gynecologists. Page 4 of 5
Appendix 4. Opioid consumption up to 60 hours postoperatively in morphine milligram equivalents (MME) in placebo transcutaneous electrical nerve stimulation (TENS) and no TENS groups. The box represents the interquartile range (IQR) containing the middle 50% of cases, the horizontal line within the box represents the median with the numerical value noted above the line, the
whiskers are lines that extend from the upper edge of the box to the highest values <1.5 times the IQR, the data points beyond the whiskers represent outliers (between 1.5 and 3 times the IQR), asterisk represents extreme outliers (more than 3 times the IQR). Kruskal Wallis test, P=.57.
Kurata NB, Ghatnekar RJ, Mercer E, Chin JM, Kaneshiro B, Yamasato KS. Transcutaneous electrical nerve stimulation for post–cesarean delivery pain control: a randomized controlled trial. Obstet Gynecol 2022;139.
The authors provided this information as a supplement to their article.
©2022 American College of Obstetricians and Gynecologists. Page 5 of 5
Electrical Nerve Stimulation (TENS) Compared With Placebo TENS
No TENS Placebo TENS P
Postoperative Day 1 n= 60 n= 59
Current pain score 2.0 (3.8) 2.0 (3.0) 0.98
Maximum pain score in past 24 hours 4.0 (4.5) 4.0 (3.0) 0.54 Satisfaction with pain control* 10.0 (1.0) 10.0 (2.0) 0.86
Postoperative Day 2 n= 52 n= 50
Current pain score 3.0 (2.0) 3.0 (4.0) 0.51
Maximum pain score in past 24 hours 5.0 (3.8) 5.0 (3.0) 0.79 Satisfaction with pain control 10.0 (1.0) 10.0 (3.0) 0.35
Postoperative Day 3 n= 36 n= 32
Current pain score 2.0 (2.0) 3.0 (3.0) 0.06
Maximum pain score in past 24 hours 4.0 (4.0) 5.5 (2.0) 0.06 Satisfaction with pain control 10.0 (1.0) 10.0 (3.0) 0.14
TENS, transcutaneous electrical nerve stimulation Data are median (interquartile range).
* Pain and satisfaction scores based on 11-point Likert scale (0 = no pain, 10 = worst pain imaginable), satisfaction based on 11-point Likert scale (0 = not satisfied, 10 = very satisfied)
