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Poster Session 1

Category: Operative Obstetrics

Poster Session 1

(364) Transcutaneous Electrical Nerve Stimulation (TENS) for Post-Cesarean Pain Relief: A Prospective Quasi-Randomized Controlled Trial

Wednesday, February 11, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Shir Zagdon Keidar, MD (she/her/hers)

Resident in Obstetrics and Gynecology
Soroka University Medical Center, Ben-Gurion University of the Negev
Beer sheva, HaDarom, Israel

Coauthor(s)

ZY

Zehava Yohay, MA

Certified Nurse Midwife; Pain Management Coordinator, Obstetrics Department
Soroka University Medical Center, Department of Obstetrics and Gynecology, Beer Sheva, Israel
Beer sheva, HaDarom, Israel
AB

Avi Barach, MSc

Head of Physical Therapy Department
Soroka University Medical Center, Beer Sheva, Israel
Beer sheva, HaDarom, Israel
IS

Irena Shtilman, MSc

Senior Physical Therapist
Soroka University Medical Center, Beer Sheva, Israel
Beer sheva, HaDarom, Israel
MS

Masho Salomon, MA

Head Nurse, Maternity Ward B
Soroka University Medical Center, Ben-Gurion University of the Negev
Beer sheva, HaDarom, Israel
Eyal Sheiner, MD, PhD

Deichmann Lerner Full Professor of Obstetrics & Gynecology; Chairman of the Division of OBY&GYN
Soroka University Medical Center, Faculty of Health Sciences, Ben‑Gurion University of the Negev
beer sheva, HaDarom, Israel

Objective:
Post-cesarean pain management is a critical component of postoperative care, directly influencing maternal recovery. Despite widespread use of pharmacological analgesia, there is growing interest in non-pharmacological methods such as transcutaneous electrical nerve stimulation (TENS). The present study aimed to evaluate the efficacy of TENS in reducing postoperative pain following cesarean delivery (CD), and to explore its potential impact on maternal-infant bonding, postnatal anxiety, and depressive symptoms.

Study Design:
A prospective quasi-randomized controlled study included 140 women undergoing CD at a tertiary medical center. Participants received either postoperative TENS (intervention group, n=70) or standard care (n=70) per a predefined allocation scheme. Pain intensity was assessed before and after each TENS session using a visual analog scale (VAS). Bonding (PBQ), anxiety (STAI), and depression (EPDS) were evaluated using validated tools. The sample size was calculated to detect a 1.5-unit difference in VAS scores (44 per group) and a 20% reduction in analgesic use (63 per group), with α=0.05 and 80% power.

Results:
Women in the TENS group experienced a significant reduction in VAS pain scores following each treatment session (Session 1: p< 0.001; Sessions 2 and 3: p=0.009; Figure). A decrease was observed in the use of a specific oral analgesic (p=0.012). This difference remained statistically significant after adjustment for maternal age (β=-0.2, 95% CI -0.8, -0.05; p=0.029) or surgical history (β=-0.2, 95% CI -0.8,-0.04; p=0.032) using linear regression models. However, no significant differences were found between the groups in the overall proportion of women with high medication consumption during hospitalization, early postpartum mobility, maternal-infant bonding, anxiety scores, or rates of postpartum depressive symptoms (EPDS ≥10; Table).

Conclusion:
TENS therapy after CD significantly reduces postoperative pain, with the potential to reduce the use of oral analgesics. Larger studies are warranted to validate these findings and further explore psychosocial benefits.