Effect of Transcutaneous Electrical Nerve Stimulation on PODD in Bariatric Surgery Patients
Effect of Transcutaneous Electrical Nerve Stimulation on Postoperative Diaphragmatic Dysfunction in Morbidly Obese Patients Undergoing Bariatric Surgery: A Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Bariatric surgery is associated with several postoperative consequences, including challenging pain control, respiratory complications, and diaphragmatic dysfunction. Postoperative diaphragmatic dysfunction is defined as a diaphragmatic excursion of less than 10 mm. There is substantial evidence that diaphragmatic ultrasound provides a reliable and accurate assessment of diaphragmatic function in both intensive care unit and perioperative settings.
The present randomized controlled trial aims to evaluate the influence of transcutaneous electrical nerve stimulation on postoperative diaphragmatic dysfunction in morbidly obese patients undergoing bariatric surgery.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Mina Adolf Helmy, MD
- Phone Number: 01275716942
- Email: minaadolf1988@cu.edu.eg
Study Locations
-
-
-
Cairo, Egypt
- Recruiting
- Cairo University Hospitals
-
Contact:
- Mina Adolf Helmy, MD
- Phone Number: 01275716942
- Email: minaadolf1988@cu.edu.eg
-
Cairo, Egypt
- Not yet recruiting
- Cairo University Hospitals
-
Contact:
- Mina Adolf Helmy, MD
- Phone Number: 01275716942
- Email: minaadolf1988@cu.edu.eg
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Body mass index > 40 kg/m2
- ASA II
Exclusion Criteria:
- Limited diaphragmatic ultrasound views
- Patient with pulmonary diseases (COPD, bronchial asthma, and interstitial fibrosis)
- Patient refusal
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: TENS
Three times daily for the first postoperative day, each session will last 30 minutes
|
The EM49 will be set to a TENS program with a frequency of 80-100 Hz and a pulse width of 200 μs
|
|
Sham Comparator: Control
Electrodes will be placed identically, but no current will be delivered (sham TENS)
|
Electrodes will be placed identically, but no current will be delivered (sham TENS)
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of postoperative diaphragmatic dysfunction
Time Frame: 2 hours after surgery
|
Diaphragmatic excursion < 10 mm 2 hours after surgery
|
2 hours after surgery
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Forced vital capacity (liters)
Time Frame: Before and at 2 and 24 hours postoperatively
|
is the maximum volume of air that can forcibly exhaled after taking maximum breath
|
Before and at 2 and 24 hours postoperatively
|
|
Numeric rating scale
Time Frame: Within 24 hours after surgery
|
To quantify pain from 0 to 10 (with 10 indicates worst pain)
|
Within 24 hours after surgery
|
|
Nalbuphine consumption
Time Frame: 24 hours after surgery
|
Total postoperative nalbuphine consumption
|
24 hours after surgery
|
|
Forced expiratory volume in one second (Liter)
Time Frame: Before and at 2 and 24 hours
|
Maximum volume of air can be exhaled in the first second after maximum inspiration
|
Before and at 2 and 24 hours
|
|
Peak expiratory flow rate (Liter/ second)
Time Frame: Baseline, 2, and 24 hours after surgery
|
Maximum flow rate during forced expiration after maximum inhalation
|
Baseline, 2, and 24 hours after surgery
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Tashani O, Johnson M. Transcutaneous Electrical Nerve Stimulation (TENS) A Possible Aid for Pain Relief in Developing Countries? Libyan J Med. 2009 Jun 1;4(2):62-5. doi: 10.4176/090119.
- Helmy MA, Mostafa MS, Saber AT, Ali MA, Milad LM. Erector Spinae Plane Block and its Impact on Postoperative Diaphragmatic Dysfunction in Morbidly Obese Patients Undergoing Laparoscopic Sleeve Gastrectomy: A Double-Blind Randomized Control Trial. Obes Surg. 2025 Dec;35(12):5228-5236. doi: 10.1007/s11695-025-08337-y. Epub 2025 Nov 4.
- Norskov J, Skaarup SH, Bendixen M, Tankisi H, Morkved AL, Juhl-Olsen P. Diaphragmatic dysfunction is associated with postoperative pulmonary complications and phrenic nerve paresis in patients undergoing thoracic surgery. J Anesth. 2024 Jun;38(3):386-397. doi: 10.1007/s00540-024-03325-5. Epub 2024 Mar 28.
- Mostafa SF, Abdelghany MS, Abu Elyazed MM. Ultrasound-Guided Erector Spinae Plane Block in Patients Undergoing Laparoscopic Bariatric Surgery: A Prospective Randomized Controlled Trial. Pain Pract. 2021 Apr;21(4):445-453. doi: 10.1111/papr.12975. Epub 2021 Jan 22.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Other Study ID Numbers
Other Study ID Numbers
- TENS and PODD in bariatric
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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