Gynecology World Conference 2026

Abstract

Postoperative pain following caesarean section is a significant contributor to delayed maternal recovery, reduced mobility, impaired breastfeeding, and decreased overall maternal satisfaction. While pharmacological analgesics remain the cornerstone of pain management, their use—particularly opioids—is limited due to potential maternal sedation and neonatal adverse effects. Therefore, there is increasing interest in safe and effective non-pharmacological adjuncts such as Transcutaneous Electrical Nerve Stimulation (TENS).

This prospective randomized study was conducted over a period of 18 months in a tertiary care center to evaluate the effectiveness and safety of TENS therapy in reducing postoperative pain following caesarean section. A total of 200 women undergoing uncomplicated caesarean delivery were enrolled and randomized into two groups: the TENS group (n=100), which received TENS therapy in addition to standard postoperative analgesia, and the control group (n=100), which received standard analgesia alone. TENS therapy was initiated within 2 hours of surgery, with electrodes placed around the abdominal incision site.

Pain intensity was assessed using the Visual Numeric Scale (VNS) and Numeric Rating Scale (NRS) at baseline and at 2, 6, 24, and 48 hours postoperatively. Statistical analysis was performed using SPSS version 25, with p-values <0.05 considered statistically significant.

The results demonstrated a significantly greater reduction in pain scores in the TENS group compared to the control group. The mean reduction in VNS scores was 4.0 ± 0.8 in the TENS group versus 1.8 ± 1.0 in the control group (p < 0.001). Similarly, the reduction in NRS scores was significantly higher in the TENS group (3.9 ± 0.8) compared to the control group (1.7 ± 1.0) (p < 0.001). Postoperative pain scores were also significantly lower in the TENS group at all measured intervals. No significant differences were observed between the groups in terms of maternal vital parameters or neonatal outcomes, including APGAR scores and birth weight. Additionally, no major adverse effects related to TENS therapy were reported.

In conclusion, TENS therapy is a safe, effective, and non-invasive adjunct for postoperative pain management following caesarean section. Its use significantly reduces pain intensity and may decrease dependence on pharmacological analgesics, thereby improving maternal recovery and overall postoperative outcomes.