Transcutaneous Electrical Nerve Stimulation (TENS) for Pain Control During First Trimester Abortion

NCT ID: NCT03187002

Last Updated: 2020-11-02

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

109 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-01-18

Study Completion Date

2019-10-31

Brief Summary

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High-frequency, high-intensity transcutaneous electrical nerve-stimulation (TENS) is an inexpensive and non-invasive pain control approach. TENS, pulsating electrical currents that activate underlying nerves, does not have drug interactions or risk of overdose. Cochrane review of TENS for acute pain found inconclusive evidence. One previous abortion trial comparing TENS to IV sedation only looked at pain control in the recovery room. The investigators propose a randomized controlled trial comparing TENS to IV sedation (in conjunction with local anesthesia) among women presenting for first-trimester surgical abortion. Primary outcome will be perceived pain by Visual Analogue Scale (VAS) during aspiration.

Detailed Description

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Conditions

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Abortion in First Trimester

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Transcutaneous electrical nerve stimulation (TENS)

Transcutaneous electrical nerve stimulation (TENS)

Group Type EXPERIMENTAL

Transcutaneous electrical nerve stimulation (TENS)

Intervention Type DEVICE

Transcutaneous electrical nerve-stimulation (TENS) is a nonpharmacologic means of pain control that delivers electrical currents through the skin. These pulses of electrical current reduce pain by peripheral and central mechanisms, TENS actives descending inhibitory systems in the central nervous system to reduce sensitivity to pain (hypoalgesia). Assessment of previous TENS research identifies intensity as a critical factor in efficacy-documenting high intensity as the best means of pain control, as the higher pulse allows for deeper tissue afferents to be activated. TENS has been researched in a number of settings as pain control, including cancer pain, lower back pain, labor, and a range of gynecologic procedures and disorders.

SHAM: Moderate IV Sedation

Intervention Type OTHER

Sham IV to ensure blinding

Moderate IV Sedation

Fentanyl, versed

Group Type ACTIVE_COMPARATOR

Moderate IV Sedation

Intervention Type DRUG

IV sedation with fentanyl and versed

SHAM: Transcutaneous electrical nerve stimulation (TENS)

Intervention Type OTHER

Sham Transcutaneous electrical nerve stimulation (TENS) to ensure blinding

Interventions

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Transcutaneous electrical nerve stimulation (TENS)

Transcutaneous electrical nerve-stimulation (TENS) is a nonpharmacologic means of pain control that delivers electrical currents through the skin. These pulses of electrical current reduce pain by peripheral and central mechanisms, TENS actives descending inhibitory systems in the central nervous system to reduce sensitivity to pain (hypoalgesia). Assessment of previous TENS research identifies intensity as a critical factor in efficacy-documenting high intensity as the best means of pain control, as the higher pulse allows for deeper tissue afferents to be activated. TENS has been researched in a number of settings as pain control, including cancer pain, lower back pain, labor, and a range of gynecologic procedures and disorders.

Intervention Type DEVICE

Moderate IV Sedation

IV sedation with fentanyl and versed

Intervention Type DRUG

SHAM: Transcutaneous electrical nerve stimulation (TENS)

Sham Transcutaneous electrical nerve stimulation (TENS) to ensure blinding

Intervention Type OTHER

SHAM: Moderate IV Sedation

Sham IV to ensure blinding

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Presenting for surgical abortion
* Gestational age \<12 weeks
* \< 18 years of age
* Agrees to be randomized

Exclusion Criteria

* Allergy to study medications (lidocaine, fentanyl, midazolam)
* \> 18 years of age
* Fetal demise
* Pre-procedure use of misoprostol
* No means of transportation following procedure
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Stanford University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Principal Investigator, MD

Role: PRINCIPAL_INVESTIGATOR

Stanford University

Locations

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Planned Parenthood Mar Monte

San Jose, California, United States

Site Status

Countries

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United States

References

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Lerma K, Goldthwaite LM, Blumenthal PD, Shaw KA. Transcutaneous Electrical Nerve Stimulation for Pain Management of Aspiration Abortion up to 83 Days of Gestation: A Randomized Controlled Trial. Obstet Gynecol. 2021 Sep 1;138(3):417-425. doi: 10.1097/AOG.0000000000004502.

Reference Type DERIVED
PMID: 34352845 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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IRB-41589

Identifier Type: -

Identifier Source: org_study_id