Review Article

Transcutaneous Electrical Nerve Stimulation (TENS) for Opioid-Induced Constipation in Palliative Care: A Systematic Review and Network Meta-Analysis

Table 2

Summaries of the interventions and clinical outcomes in this study.

Study, year (reference)AgeParticipants, nAnalgesic measuresTypes of cancerInterventionsElectrical stimulation pointsTreatment protocols for TENSConstipation
Treatment groupControl groupTreatment groupControl groupTreatment groupControl groupTreatment groupControl groupTreatment groupControl group

Li, 2014 [24]52.9 ± 18.353.2 ± 18.58590OHDT and TENSOHDT: gradually adjusted until a stable analgesic doseMultiple types of cancerTENSN/ATianshuN/AIR: 22/85 (25.9%)IR: 43/90 (47.8%)

Li, 2015 [25]N/AN/A4753OHDT and TENSOHDT: gradually adjusted until a stable analgesic doseMultiple types of cancerTENSN/ATianshuN/AIR: 25/47 (53.2%)IR: 37/53 (69.8%)

Weng, 2015 [26]62.5 ± 11.365.1 ± 10.89291OHDT and TENSOHDT: gradually adjusted until a stable analgesic doseMultiple types of cancerTENSN/ATianshuN/AIR: 13/92 (14.13%)IR: 25/91 (27.47%)

Wu, 2017 [27]47.41 ± 11.8449.13 ± 10.388481OHDT, TENS, and oral Xiaoji Zhitong decoctionOHDT: gradually adjusted until a stable analgesic doseMultiple types of cancerTENSN/ATianshuN/AIR: 19/84 (10.7%)IR: 36/81 (44.4%)

Deng, 2017 [28]56.1.1 ± 4.63939OHDT and TENSOHDT: gradually adjusted until a stable analgesic doseMultiple types of cancerTENSN/ATianshu30 consecutive days, the stimulation current intensity gradually increased so that the patient could still tolerate itIR: 16/39 (41.0%)IR: 27/39 (69.2%)

Du, 2019 [29]59.1 ± 1.658.2 ± 1.62424OHDT and TENSOHDT: gradually adjusted until a stable analgesic doseBone metastases cancerTENSN/ADazhu; Shenshu; Zusanli; Sanyinjiao30 min/time, 1 time/d, 4 consecutive weeks; electrical nerve stimulator parameter setting: a dilatational wave (frequency 2–100 Hz) and bearable current intensity were usedIR: 13/24 (54.2%)IR: 20/24 (83.3%)
Yang, 2021 [30]63.87 ± 9.0264.43 ± 10.923030OHDT and TENSOHDT: WHO pain treatment paradigmMultiple types of cancerTENSN/AKongzui; Taichong; Siguan; Zusanli; Neiguan20−30 min/time, 1 time/d, 7 consecutive days; electrical nerve stimulator parameter setting: a dilatational wave (frequency 2/100 Hz) and bearable current intensity were usedIR: 24/30 (80.00%)IR: 26/30 (86.67%)

Zhu, 2018 [31]57.12 ± 9.9359.54 ± 10.775860OHDT and TENSOHDT: ≥80 mg/dayNo descriptionTENSLactulose oral solutionTianshu; Zhongwan80–120 Hz; 30 min/day, 2 consecutive weeksER: (76.5%)70.00%
PAC-QOL: −9.32 ± 1.81−7.02 ± 2.21

Cai, 2019 [11]51.2 ± 3.455.3 ± 3.1124127OHDT and TENSOHDT: gradually adjusted until a stable analgesic doseMultiple types of cancerTENSLactulose oral solutionGuanyuan; Qihai; Tianshu; Zusanli; Shangjuxu30 min/time, 1 time/d, 14 consecutive days; electrical nerve stimulator parameter setting: a dilatational wave (frequency 2/100 Hz) and bearable current intensity were usedER: 114/124 (91.9%)ER: 109/127 (85.8%)
PAC-QOL: −1.6 ± 0.30.05 ± 0.41

OHDT, oxycodone hydrochloride delayed-release tablets; TENS, transcutaneous electrical nerve stimulation; IR, incidence rate; ER, effective rate; NCCN clinical practice guidelines in oncology (version 2 2011) and the following formulas: transdermal fentanyl (25 mcg/h) ≈ oral oxycodone (30 mg/d) ≈ parenteral morphine (20 mg/day) ≈ oral morphine (60 mg/day).