Effect of microcurrent skin patch on the epidural fentanyl requirements for post operative pain relief of total hip arthroplasty

ABSTRACT

Major orthopedic surgery that cause considerable pain like total hip arthroplasty, requires good post operative pain management. Microcurrent therapy [MCT] is a new therapy whereby electric current is provided in literally millionth of an ampere. MCT comes as two self adherent active electrode patches linked by a cable efficacy of MCT in the management of musculoskeletal pain and enhancement of wound healing has been reported. To study the effect of microcurrent therapy [MCT] on the epidural fentanyl requirements and degree of wound healing after total hip arthroplasty. Twenty eight patients undergoing total hip replacement [THR] were randomly allocated into two groups. Group I had micro current skin patches [two adhesive electrode] attached above the site of operation in addition to the lumbar epidural catheter. Post operative epidural fentanyl infusion with a syringe pump given at a rate ranged between 25 and 75 microgram per hour to keep visual analogue pain score [VAS] less than 3/10. Group II had only continuous epidural infusion with fentanyl at the same range to keep VAS less than 3/1 without MCT. There was statistically significant lower mean epidural fentanyl requirement in Group I [23.24 microgram] when compared to Group II [58.36 microgram]. There was 23% incidence of dermatitis in Group I due to application of micro-current skin patch which resolved by treatment. There was statistically significant higher frequency of grade 1 of wound healing in the microcurrent group [41.3%] when compared to Group II [7.2%]. Grade 2 and 3 were more frequent in Group II] The microcurrent skin therapy lead to reduction in the requirements of the post operative epidural fentanyl with improvement of degrees of wound healing but with considerable incidence of skin dermatitis after total hip arthroplasty