TENS Use for Post-cesarean Pain Management

The aim of this randomized controlled trial is to evaluate the effectiveness of continuous 24-hour Transcutaneous Electrical Nerve Stimulation (TENS) as an adjunct to standard postoperative care for pain management following cesarean delivery. Eligible women undergoing cesarean delivery under spinal anesthesia will be randomly assigned in a 1:1 ratio to either the intervention group, which will receive continuous TENS in addition to standard postoperative analgesia, or the control group, which will receive standard postoperative analgesia alone. The primary outcome is the Quality of Recovery-15 (QoR-15) score assessed 24 hours after cesarean delivery.

Inclusion Criteria: * Women aged 18-45 years. * Undergoing CD under spinal anesthesia. * Hemodynamically stable postoperatively. * Able to provide informed consent. Exclusion Criteria: * Undergoing CD under epidural or general anesthesia. * Skin lesions or infection at electrode placement sites. * Pacemaker or implanted electrical devices. * Neurological disorders affecting pain perception. * Chronic opioid use or chronic pain disorders. * Allergy or other contraindication to opioids, nonsteroidal antiinflammatory drugs, or acetaminophen use. * Adhesive allergy. * Midline vertical skin incision (in the current or previous cesarean). * Intraoperative sterilization. * Cesarean hysterectomy.