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  • High-Frequency Transcutaneous Electrical Nerve Stimulation Attenuates Postsurgical Pain and Inhibits Excess Substance P in Rat Dorsal Root Ganglion

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High-Frequency Transcutaneous Electrical Nerve Stimulation Attenuates Postsurgical Pain and Inhibits Excess Substance P in Rat Dorsal Root Ganglion
  1. Yu-Wen Chen, PhD*,†,
  2. Jann-Inn Tzeng, MS, MD‡,§,
  3. Min-Fei Lin, MS∥,
  4. Ching-Hsia Hung, PhD∥,
  5. Pei-Ling Hsieh, MS∥ and
  6. Jhi-Joung Wang, MD, PhD†
  1. *Department of Physical Therapy, China Medical University, Taichung
  2. †Department of Medical Research, Chi-Mei Medical Center
  3. ‡Department of Food Sciences and Technology, Chia Nan University of Pharmacy and Science, Jen-Te
  4. §Department of Anesthesiology, Chi-Mei Medical Center, Yong Kang
  5. ∥Institute and Department of Physical Therapy, National Cheng Kung University, Tainan City, Taiwan
  1. Address correspondence to: Ching-Hsia Hung, PhD, Institute and Department of Physical Therapy, National Cheng Kung University, No. 1 Ta-Hsueh Rd, Tainan, Taiwan (e-mail: chhung{at}mail.ncku.edu.tw).

Abstract

Background Transcutaneous electrical nerve stimulation (TENS) is a common therapeutic modality for pain management, but its effectiveness in skin/muscle incision and retraction (SMIR)–evoked pain is unknown. We aimed to examine the effects of TENS on postoperative pain and the levels of substance P (SP), N-methyl-D-aspartate receptor 1 (NR1), and interleukin 1β (IL-1β) in rat dorsal root ganglion (DRG).

Methods High-frequency (100 Hz) TENS was administered daily beginning on postoperative day 1 (POD1) and continued until animal subjects were killed for tissues. Mechanical sensitivity to von Frey stimuli (6g and 15g) and the levels of NR1, SP, and IL-1β in DRG were assessed in the sham-operated, SMIR-operated, TENS after SMIR surgery, and placebo-TENS after SMIR surgery groups.

Results Skin/muscle incision and retraction rats exhibited a significant hypersensitivity to von Frey stimuli on POD3. In contrast with SMIR rats, SMIR-operated rats receiving TENS therapy demonstrated a rapid recovery of mechanical hypersensitivity. The SMIR-operated rats showed an up-regulation of NR1, SP, and IL-1β in DRG on PODs 14 and 28, whereas the SMIR-operated rats after TENS administration reversed this up-regulation. By contrast, the placebo-TENS after SMIR operation did not alter postsurgical pain nor the levels of NR1, SP, and IL-1β.

Conclusions Our data demonstrated that TENS intervention reduced persistent postoperative pain caused by SMIR operation. Up-regulation of NR1, SP, and IL-1β in DRG, activated after SMIR surgery, is important in the development of prolonged postincisional pain. The TENS pain relief may be related to the suppression of NR1, SP, and IL-1β in DRG of SMIR rats.

http://dx.doi.org/10.1097/AAP.0000000000000091

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    Footnotes

    • The authors declare no conflict of interest.

      This study was supported by the National Science Council, Taiwan (grants NSC 100-2314-B-039-017-MY3 and NSC 101-2314-B-006-037-MY3).