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Fastens-a disposable transcutaneous electrical nerve stimulator designed specifically for use in postoperative patients
SURGEON’S WORKSHOP
FASTENS-A ELECTRICAL SPECIFICALLY
DANIEL
DISPOSABLE NERVE FOR
C. MERRILL,
TRANSCUTANEOUS STIMULATOR
USE
IN POSTOPERATIVE
PATIENTS
M.D.
From the Veterans Administration Martinez, California
Transcutaneous electrical nerve stimulation (TENS) provides an effective method of controlling postoperative incisional pain. A recent clinical evaluation of patients who had nephrectomy, retropubic prostatectomy, or implantation of an inflatable penile prosthesis showed that patients treated with electroanalgesia used 68 per cent less pain medication and made 84 per cent fewer requests for Demerol than did controls who were not treated with TENS.* In fact, 50 per cent of TENS patients who had radical retropubic prostatectomies or implantation of an inflatable penile prosthesis and 25 per cent of patients who had nephrectomies required no parenteral analgesic during their convalescence. In the past, the only stimulators available for postoperative electroanalgesia were the standard TENS devices designed for the control of chronic pain. Unfortunately, the cost of these expensive stimulators is a significant monetary impediment to the use of postoperative electroanalgesia, especially in outpatients who may damage or lose the devices. There also are practical limitations to the use of chronic TENS units in postoperative patients. The chronic TENS stimulators require frequent battery replacement, are difficult for postoperative patients to carry, and, most importantly, are difficult for surgeons not experienced in TENS to *Merrill DC: Electroanalgesia in urologic surgery, Urology 29: 494 (1987).
78
DESIGNED
Medical Center,
FIGURE1.
FasTENS unit with pair of Sinch electrodes. To increase or decrease voltage amplitude upper and lower touch-sensitive triangles are compressed, respectively. Voltage amplitude selected is indicated by red light in central light emitter diode.
UROLOGY
/
JANUARY 1988
/
VOLUME XxX1,
NUMBER
1
limited battery life which varies between three to seven days depending on whether 3-, 6-, or 9inch electrodes are used. The batteries are not replaceable and patients who require long electrodes, which utilize more electrical energy, or prolonged postoperative electroanalgesia may require the use of a second FasTENS unit during their convalescence. Alternatively, a chronic TENS unit with replaceable batteries may be employed in clinical situations such as thoracotomy which requires the use of g-inch electrodes and prolonged postoperative electroanalgesia. In conclusion, FasTENS provides a simple, inexpensive method of administering postoperative electroanalgesia. The disposable unit is particularly applicable to surgical patients who require 3- to 6-inch electrodes and five to seven days of stimulation. Standard TENS units may be more suitable for patients subjected to thoracotomies and other surgical procedures which require long electrodes and prolonged postoperative electroanalgesia.
use because correct adjustments in pulse frequency, pulse rate, and voltage amplitude must be made to achieve maximal pain control. FasTENS is an inexpensive disposable TENS stimulator designed specifically for use in postoperative patients (Fig. 1). The unit may be used with any sterile disposable postoperative electrode. The FasTENS stimulator is simple to operate because only the voltage amplitude need be adjusted; all other pulse parameters are preset. The FasTENS units also are easy for the patient to carry because they are light-weight and are easily clipped to the patient’s hospital gown. I am presently performing a study which compares the clinical effectiveness of the disposable FasTENS unit with a chronic TENS stimulator in patients who have had urologic surgery. The preliminary results of this study suggest that the disposable FasTENS devices are as effective as the chronic TENS units in controlling acute postoperative pain. As expected, FasTENS is much easier for patient and staff to use than are the chronic TENS devices. The only limitation to the use of the disposable unit is its
UROLOGY
/ JANUARY 1988
I
VOLUME
XxX1, NUMBER
Martinez,
1
California
94553
79
FASTENS-A ELECTRICAL SPECIFICALLY
DANIEL
DISPOSABLE NERVE FOR
C. MERRILL,
TRANSCUTANEOUS STIMULATOR
USE
IN POSTOPERATIVE
PATIENTS
M.D.
From the Veterans Administration Martinez, California
Transcutaneous electrical nerve stimulation (TENS) provides an effective method of controlling postoperative incisional pain. A recent clinical evaluation of patients who had nephrectomy, retropubic prostatectomy, or implantation of an inflatable penile prosthesis showed that patients treated with electroanalgesia used 68 per cent less pain medication and made 84 per cent fewer requests for Demerol than did controls who were not treated with TENS.* In fact, 50 per cent of TENS patients who had radical retropubic prostatectomies or implantation of an inflatable penile prosthesis and 25 per cent of patients who had nephrectomies required no parenteral analgesic during their convalescence. In the past, the only stimulators available for postoperative electroanalgesia were the standard TENS devices designed for the control of chronic pain. Unfortunately, the cost of these expensive stimulators is a significant monetary impediment to the use of postoperative electroanalgesia, especially in outpatients who may damage or lose the devices. There also are practical limitations to the use of chronic TENS units in postoperative patients. The chronic TENS stimulators require frequent battery replacement, are difficult for postoperative patients to carry, and, most importantly, are difficult for surgeons not experienced in TENS to *Merrill DC: Electroanalgesia in urologic surgery, Urology 29: 494 (1987).
78
DESIGNED
Medical Center,
FIGURE1.
FasTENS unit with pair of Sinch electrodes. To increase or decrease voltage amplitude upper and lower touch-sensitive triangles are compressed, respectively. Voltage amplitude selected is indicated by red light in central light emitter diode.
UROLOGY
/
JANUARY 1988
/
VOLUME XxX1,
NUMBER
1
limited battery life which varies between three to seven days depending on whether 3-, 6-, or 9inch electrodes are used. The batteries are not replaceable and patients who require long electrodes, which utilize more electrical energy, or prolonged postoperative electroanalgesia may require the use of a second FasTENS unit during their convalescence. Alternatively, a chronic TENS unit with replaceable batteries may be employed in clinical situations such as thoracotomy which requires the use of g-inch electrodes and prolonged postoperative electroanalgesia. In conclusion, FasTENS provides a simple, inexpensive method of administering postoperative electroanalgesia. The disposable unit is particularly applicable to surgical patients who require 3- to 6-inch electrodes and five to seven days of stimulation. Standard TENS units may be more suitable for patients subjected to thoracotomies and other surgical procedures which require long electrodes and prolonged postoperative electroanalgesia.
use because correct adjustments in pulse frequency, pulse rate, and voltage amplitude must be made to achieve maximal pain control. FasTENS is an inexpensive disposable TENS stimulator designed specifically for use in postoperative patients (Fig. 1). The unit may be used with any sterile disposable postoperative electrode. The FasTENS stimulator is simple to operate because only the voltage amplitude need be adjusted; all other pulse parameters are preset. The FasTENS units also are easy for the patient to carry because they are light-weight and are easily clipped to the patient’s hospital gown. I am presently performing a study which compares the clinical effectiveness of the disposable FasTENS unit with a chronic TENS stimulator in patients who have had urologic surgery. The preliminary results of this study suggest that the disposable FasTENS devices are as effective as the chronic TENS units in controlling acute postoperative pain. As expected, FasTENS is much easier for patient and staff to use than are the chronic TENS devices. The only limitation to the use of the disposable unit is its
UROLOGY
/ JANUARY 1988
I
VOLUME
XxX1, NUMBER
Martinez,
1
California
94553
79