TENS no better than sham for managing pain during early procedural abortion

In the management of pain during first-trimester procedural abortion, transcutaneous electrical nerve stimulation (TENS) does not prove superior to sham stimulation, as shown in a study.

The double-blinded, block-randomized superiority trial included 70 women in their first trimester of pregnancy (<12 weeks of gestation) who were undergoing procedural abortion and were not eligible for or were forgoing sedation. These women were assigned to receive TENS or the sham to manage pain.

The primary outcome was self-reported pain by visual analogue scale (VAS, 100 mm) during passage of largest cervical dilator. A 15-mm difference in median pain score was set to establish superiority.

Baseline demographics were similar between the TENS and sham groups, with median gestational duration being 6 weeks and 35.7 percent being nulliparous.

The median reported pain with passage of largest dilator did not differ between the TENS and sham groups, at 44 and 50 mm, respectively (p=0.56). Likewise, no significant between-group difference in median pain was observed at any collected time point including placement of tenaculum, paracervical block, aspiration, or recovery.

However, women in the TENS group were more likely to say they would recommend this method of pain control to others compared with those in the sham group (94 vs 73 mm; p=0.01). Significantly more women receiving TENS unit correctly identified their group allocation (91.4 percent vs 63.6 percent; p< 0.001).