Effects of transcutaneous electrical nerve stimulation on pain intensity during application of carboxytherapy in patients with cellulite: A randomized placebo-controlled trial.

BACKGROUND: Carboxytherapy may generate local pain that is considered the main limiting factor in clinical practice. Transcutaneous electric nerve stimulation (TENS) is widely used in the control of acute pain; however, the effect of TENS on pain relief during carboxytherapy has not been studied to date. AIMS: To assess the effect of TENS on pain intensity during carboxytherapy in patients with cellulite in the gluteal region. PATIENTS/METHODS: This randomized clinical trial was conducted with 84 patients, 18-44 years of age, who had moderate cellulite in the gluteal region, according to Cellulite Severity Scale, but never received carboxytherapy. Patients were randomized into 3 groups: active TENS, placebo TENS, and control group. For the intervention, skin depressions with cellulite were outlined, and the gluteal area to be treated was defined. The subcutaneous injection of CO2 was performed using 0.30 × 13 mm-needles at a 45° angle, with a controlled flow rate of 100 mL/min maintained for 1 minute at each puncture site. The parameters for TENS were as follows: frequency of 100 Hz and pulse duration of 200 µs; TENS intensity was adjusted until the patient reported strong paresthesia. The visual numeric pain rating scale was used to assess pain intensity after each puncture. RESULTS: The active TENS group reported lower pain intensity compared to the placebo TENS (P < .0001) and control (P < .0001) groups. CONCLUSIONS: Transcutaneous electric nerve stimulation (TENS) was effective in reducing pain intensity during carboxytherapy in patients with cellulite in the gluteal region.

Effect of High- and Low-Frequency Transcutaneous Electrical Nerve Stimulation on Angiogenesis and Myofibroblast Proliferation in Acute Excisional Wounds in Rat Skin.

OBJECTIVE: This study evaluated the effects of high- (HF) and low-frequency (LF) transcutaneous electrical nerve stimulation on angiogenesis and myofibroblast proliferation in acute excisional wounds in rat skin. DESIGN: This was an experimental controlled and randomized study. PARTICIPANTS: An excisional wound was made on the back of 90 adult male EPM1-Wistar rats using an 8-mm punch. INTERVENTIONS: The animals were randomly assigned to the HF group (80 Hz), LF group (5 Hz), or control group. Transcutaneous electrical nerve stimulation (pulse duration, 200 microseconds; current amplitude, 15 mA) was delivered (session length, 60 minutes) on 3 consecutive days. MEAN OUTCOME MEASURE: Immunohistochemistry was performed on postoperative days 3, 7, and 14 for counting blood vessels and myofibroblasts. MEAN OUTCOME RESULTS: The LF group had significantly more blood vessels than the HF group on day 3 (P = .004). The HF group had significantly less blood vessels than did the control group on days 7 (P = .002) and 14 (P = .034) and less myofibroblasts than did both the LF and control groups on day 3 (P = .004) and less than did the control group on day 7 (P = .001). CONCLUSION: There seems to be a benefit to the use of LF transcutaneous electrical nerve stimulation in the healing of acute excisional wounds, but further studies are warranted.