Summary of findings 7. TENS compared to no TENS for relief of pain due to uterine cramping/involution after birth.
| TENS compared to no TENS for relief of pain due to uterine cramping/involution after birth | |||||
| Patient or population: women who have given birth vaginally, requiring analgesia for after‐birth pains. Setting: hospital obstetric inpatients (Brazil and Germany) Intervention: TENS Comparison: no TENS | |||||
| Outcomes | № of participants (studies) | Certainty of the evidence (GRADE) | Relative effect (95% CI) | Anticipated absolute effects* (95% CI) | |
| Risk with no TENS | Risk difference with TENS | ||||
| Adequate pain relief as reported by the woman (during next breast feed) |
32 (1 RCT) | ⊕⊝⊝⊝ VERY LOWa,b | RR 4.00 (0.50 to 31.98) | Study population | |
| 63 per 1000 | 188 more per 1000 (31 fewer to 1,936 more) | ||||
| Need for additional pain relief | Not reported | ||||
| Maternal adverse events | One study (32 women) stated "there were few adverse effects associated with TENS". | ||||
| Neonatal adverse events | Not reported | ||||
| Duration of hospital stay | Not reported | ||||
| Any breastfeeding at hospital discharge | Not reported | ||||
| Any breastfeeding at 6 weeks postpartum | Not reported | ||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; | |||||
| GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | |||||
aDowngraded one level due to serious concerns about limitations in study design: risk of bias ‐ high risk for performance and detection bias, and outcome assessment bias, unclear risk for allocation concealment. bDowngraded two levels for very serious concerns about imprecision: very few participants and wide CI.