***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract For several years Transcutaneous Electrical Nerve Stimulation ( TENS ) has been used in the management of chronic and acute pain . The aim of this trial was to determine its effectiveness in providing pain relief during labour as well as its influence on the incidence of requests for epidural analgesia . The experimental group ( receiving  TENS by a burst – conventional obstetric TENS-apparatus ) and the control population ( not receiving TENS ) consisted of 24 and 35 women respectively . In the experimental group the TENS application was switched off for a period of 15 min . The 24 women were asked to point out the intensity of their pain on a visual analogue scale before , during and after this temporary interruption . Two days postpartum the parturient ’s satisfaction was evaluated by two questions , a procedure which revealed that 96 % degree of satisfaction . The incidence of epidural analgesia in the experimental group was compared to the control-group . During TENS  application the pain scores were significantly lower ( p<0.0001 ) , but no statistically significant difference in incidence of epidural analgesia was found between the experimental group and the control group Abstract Transcutaneous electrical nerve stimulation ( TENS ) is one of the non‐pharmacological means of pain relief for labor and delivery . We aim ed to investigate the efficacy and safety of TENS on specific acupuncture points for reducing pain in the first stage of labor . In this double‐blind , placebo‐controlled trial , we r and omly assigned healthy full‐term parturients in active phase of first‐stage labor to either TENS on four acupuncture points ( Hegu [ Li 4 ] and Sanyinjiao [ Sp 6 ] ) ( n = 52 ) or the TENS placebo ( n = 53 ) . Visual analogue scale ( VAS ) was used to assess pain before and 30 and 60 min after treatment . The primary outcome was the rate of VAS score decrease ⩾3 in each group . A question naire was given at 24 h post‐partum to evaluate the satisfaction of pain relieving method and the willingness to have the same treatment again . Mode of delivery and neonatal effect were measured as secondary outcome . One hundred women were eligible for analysis .  TENS group experienced VAS score reduction ⩾3 significantly more common than the TENS placebo group ( 31/50 [ 62 % ] vs 7/50 [ 14 % ] , P < 0.001 ) . Willingness of using the same analgesic method for a future childbirth was also significantly different ( TENS : 48/50 [ 96 % ] vs TENS placebo : 33/50 [ 66 % ] , P < 0.001 ) . Operative delivery was increased in the TENS group ( 12/50 [ 24 % ] vs 4/50 [ 8 % ] , P = 0.05 ) , but the neonatal outcomes were not different . The application of TENS on specific acupuncture points could be a non‐invasive adjunct for pain relief in the first stage of labor The analgesic effects of transcutaneous electrical nerve stimulation ( TENS ) in labour and effects on outcome were investigated in a double-blind TENS/TENS placebo controlled trial in 100 primigravidae and 50 women in their third labour . There were no differences between the TENS and the TENS placebo users in terms of pain concept or relief , and only 12 and 13 % of primigravidae and 48 and 39 % of the para 2 women completed labour without requiring other analgesia in their respective groups . The primigravidae who used either TENS or TENS placebo alone had shorter labours than those who required further analgesia . Although the outcome of labour for mother and infant were similar in the two groups , there was a higher operative delivery rate in women who also had epidural analgesia . There were highly significant differences between the TENS and the TENS placebo users in terms of favourable and unfavourable comments by the mothers and the midwives at 1 and 24 h after delivery . The evident consumer satisfaction for TENS suggests TENS has a part to play in analgesia in labour but the equivocal findings in terms of factors associated with pain relief points to the need for apparatus more specifically design ed to cope with the special characteristics of the pain of labour Transcutaneous nerve stimulation ( TNS ) was applied to 100 parturients with a view of decreasing pain during labour . A control group of 100 parturients was r and omly selected . Two hours after delivery the mothers and their midwives independently completed question naires regarding the pain which was subjectively quantified , during the different stages of labour . The distribution of age and parity of the mothers , the duration of labour , and Apgar score of the neonates at one minute were comparable in the two groups . The desire for and administration of analgesic agents was equal in each group . Significantly more mothers in the TNS group reported that labour had been moderately or intensively painful compared to the control group during cervical dilatation from 1 - -7 cm . After this degree of dilation the subjective judgement regarding pain were the same in both groups . The expectation of pain during labour , as well as the experience of pain compared to expectation , was similar in both groups . Thirty-one of the mothers in the TNS group considered the pain relieving affect of the TNS good and 55 considered it moderate . Thirty-two of the mothers in the TNS group wanted a more efficient analgesic method for the next labour The effectiveness of transcutaneous nerve stimulation ( TENS ) for pain relief in labour was evaluated by r and omizing 280 patients in early labour into 2 groups . Inoperative sham machines were applied to patients in the control group and active units to those in the test group . Neither patients nor attending labour ward staff were aware of which group the patient was in . The intensity of low back pain and abdominal pain was assessed by the patient each hour on a visual analogue pain scale . Each patient served as her own control by switching off the machine for 2 contractions every hour and then recording the intensity of pain . The amount of conventional analgesia each patient received was recorded by labour ward staff . There was no difference in the intensity of pain recorded by each group . Nor was there any difference between the 2 groups in the change of pain experienced when the machine was switched off . Moreover there was no difference in the amount of other analgesia required . Some differences were found when those with little low back pain were excluded from the study . We conclude that TENS is ineffective as a routine method of pain relief in labour . It is likely to benefit only those with severe back pain and then only to a modest degree Seventy parturient women were r and omized into two groups , one receiving transcutaneous nerve stimulation , the other mock stimulation with an identical looking apparatus . The patients ' assessment of pain relief and the use of analgesics during labor were recorded . There was no difference between the two groups in the degree of pain relief . There was no reduction in the need for analgesics which could be ascribed to the use of nerve stimulation . The use of analgesics in each patient was correlated to the duration of labor The effectiveness of transcutaneous electric nerve stimulation ( TENS ) for pain relief in labour was compared to inhalation analgesia consisting of 50 % nitrous oxide and 50 % oxygen ( ENTONOX ) . In the first part of the study 101 patients in early labour were allocated to using TENS ( Group A ) or ENTONOX ( Group B ) for pain relief . Our results did not show any beneficial effect on pain relief in labour with the use of TENS over ENTONOX ; 18.8 % of patients in Group A went through labour without any further form of analgesia as opposed to 17.0 % in Group B. In the second part of the study 20 nulliparous patients having induced labour were r and omly allocated to use TENS ( Group C ) or ENTONOX ( Group D ) as the first modality of pain relief . A switchover was made when labour pains were no longer tolerable . The results showed that both TENS and ENTONOX could be used in early labour up to 5 - 6 cm cervical dilatation till the frequency of contractions was nearly 5 in 10 min or the first 3 - 4 hr from the time patients first requested pain relief in labour when frequency of contractions was nearly 4 in 10 min . TENS could be used in early labour for patients who wish to be ambulant and is as effective as ENTONOX . Either modality of pain relief was not adequate for pain relief throughout labour OBJECTIVE We examined the efficacy of transcutaneous electrical nerve stimulation ( TENS ) in general and the new Freemom TENS device ( LifeCare , Israel ) in particular , for pain relief during labor and delivery . METHODS The study group consisted of 104 women . Forty-six nulliparas ( 44.2 % ) and 58 multiparas ( 55.8 % ) , all of whom used the TENS device for pain relief during labor . All participants completed a question naire on the degree of pain relief afforded them by TENS during the delivery and related questions . The objective evaluation was based on the documented labor and delivery parameters including medical interventions during delivery . RESULTS The majority of subjects ( 72 % of the nulliparas and 69 % of the multiparas ) considered TENS effective for the relief of pain during labor . Most of them ( 67 % of the nulliparas and 60 % of the multiparas ) responded positively to the use of TENS in future deliveries . Sixty-five percent of the multiparas considered TENS at least as effective as the other pain relief methods they had used before . TENS significantly reduced the duration of the first stage of labor P < 0.001 for nulliparas , P < 0.005 for multiparas and it significantly decreased the amount of analgesics administered to individual patients . No significant difference was found in fetal heart rate tracings , Apgar scores and cord blood pH between the study group and an equal number of matched controls who used other forms of pain management . CONCLUSIONS TENS is an effective non-pharmacological , non-invasive adjuvant pain relief modality for use in labor and delivery . TENS application reduced the duration of the first stage of labor and the amount of analgesic drug administered . There were no adverse effects on mothers or newborns 
    Output:
    
There was no evidence that TENS interfered in any of the outcomes except the mothers ' desire to use TENS in future deliveries .
The use of TENS had no impact on mother or child and no influence on labor .
According to the results of this review , there is no evidence that TENS reduces the use of additional analgesia