Pulsed shortwave therapy (PSWT) did not demonstrate a statistically significant reduction in pain levels or opioid use in the immediate postoperative period, according to a study presented at the ANESTHESIOLOGY 2024 annual meeting. The randomized, controlled pilot study investigated PSWT's potential as a non-pharmacological approach to pain management following common surgical procedures.
The study involved patients recovering from primary knee and hip arthroplasty, cholecystectomy, hernia repair, or non-mastectomy breast surgery. Participants were randomized to receive either active PSWT or a sham treatment for 28 days, with the primary outcomes being cumulative opioid consumption and mean pain scores during the first week post-surgery. The PSWT device (Model 088, BioElectronics Corporation) delivered radiofrequency energy through the patients' bandages.
Lack of Significant Pain Reduction
The results indicated no significant difference in opioid consumption between the active treatment group (21 mg oxycodone) and the sham group (17 mg oxycodone), with a difference of 4 mg (95% CI, -5 to 13; P = .376). Similarly, mean daily pain scores were comparable, with 2.4 in the active group and 2.6 in the sham group (difference of -0.2; 95% CI, -0.8 to 0.5; P = .597). Maximum pain scores also showed no significant difference (4.6 vs. 4.7, P = .888).
Implications and Future Research
Researchers noted minimal differences in all daily pain severity scores, opioid consumption, and the interference of pain with physical and emotional functioning, as measured by the Brief Pain Inventory. No device-related systemic side effects or serious adverse events were reported. The authors concluded that the study failed to provide evidence that PSWT reduces pain scores and opioid requirements to a statistically significant or clinically relevant degree during the initial postoperative week.
While PSWT has been used for decades and several devices have received FDA clearance, its broad clinical adoption has been limited by a lack of robust evidence supporting its effectiveness for pain control. This study adds to the existing body of knowledge, suggesting that further research is needed to determine the optimal use of PSWT in perioperative pain management. The study authors recommend replicating these results in subsequent trials to confirm the findings and potentially refine the PSWT protocol for future investigations.
