Comparing the effect of auricular acupressure and body acupressure on pain and duration of the first stage of labor: study protocol for a randomized controlled trial

Zainab Alimoradi, Farideh Kazemi, Mahboubeh Valiani, Maryam Gorji, Zainab Alimoradi, Farideh Kazemi, Mahboubeh Valiani, Maryam Gorji

Abstract

Background: Labor pain is one of the leading causes of fear of childbirth. Acupressure is a non-pharmacological pain relief method that has shown promising results in relieving this pain. The present study is designed to compare the effects of body acupressure at multiple points and auricular acupressure on the pain and duration of labor.

Methods/design: In a randomized controlled trial, 90 primigravida women who attend for childbirth will be randomly assigned to one of three groups (intervention groups of either body acupressure or auricular acupressure; control, consisting of routine care). Computer-generated six-block randomization techniques will be used to determine the allocation sequence with a 1:1:1 ratio. To hide the allocation, the type of intervention will be written according to the generated sequence and put in opaque envelopes; these as well as questionnaires will be encoded. The pain score for all participants will be measured at the peak uterine contraction at 4-cm cervical dilation and at 10-cm dilation based on a visual analog scale (VAS). The duration of the active phase of labor in these groups will be recorded too. Data will be imported into SPSS-16 software. First, normality of the data distribution will be investigated. To compare labor duration among the research groups, ANOVA will be used, which will be followed, in case of significance, by the Scheffe post hoc test. Furthermore, Chi-squared test will be used to compare the categorized demographic variables and ANOVA or Kruskal-Wallis tests will be used to compare the quantitative variables in the studied groups. A significance level of 0.05 is considered significant.

Discussion: In this study the effect of auricular acupressure and body acupressure on pain and duration of first stage of labor will be compared.

Trial registration: Iranian Registry of Clinical Trials, IRCT20180218038789N1. Registered 2018-03-04; pre result.

Keywords: Auricular acupressure; Body acupressure; Labor duration; Labor pain.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Trial flow overview
Fig. 2
Fig. 2
Body acupoints
Fig. 3
Fig. 3
Ear acupoints
Fig. 4
Fig. 4
SPIRIT Schedule of enrolment, interventions, and assessments

References

    1. Yazdkhasti M, Pirak A. The effect of aromatherapy with lavender essence on severity of labor pain and duration of labor in primiparous women. Complement Ther Clin Pract. 2016;25:81–86. doi: 10.1016/j.ctcp.2016.08.008.
    1. Silva M, Halpern SH. Epidural analgesia for labor: Current techniques. Local Regional Anesthesia. 2010;3:143.
    1. Ghanjavi A, Paghande F, Ebrahiminejad GR. The quality and intensity of labor pain based on McGill pain Questionnaire in parturient women admitted in the maternity ward of Afzalipour Hospital in Kerman. J Kerman University Med Sci. 2011;8(2):163–171.
    1. Ogboli-Nwasor EO, Adaji SE. Between pain and pleasure: Pregnant women's knowledge and preferences for pain relief in labor, a pilot study from Zaria, Northern Nigeria. Saudi J Anaesth. 2014;8(Suppl 1):S20–S24. doi: 10.4103/1658-354X.144059.
    1. Sharma SK, Alexander JM, Messick G, Bloom SL, McIntire DD, Wiley J, et al. Cesarean delivery: a randomized trial of epidural analgesia versus intravenous meperidine analgesia during labor in nulliparous women. Anesthesiology. 2002;96(3):546–551. doi: 10.1097/00000542-200203000-00007.
    1. Arendt KW, Tessmer-Tuck JA. Nonpharmacologic labor analgesia. Clin Perinatol. 2013;40(3):351–371. doi: 10.1016/j.clp.2013.05.007.
    1. Ozgoli G, Sedigh Mobarakabadi S, Heshmat R, Alavi Majd H, Sheikhan Z. Effect of LI4 and BL32 acupressure on labor pain and delivery outcome in the first stage of labor in primiparous women: A randomized controlled trial. Complementary Therapies Med. 2016;29:175–180. doi: 10.1016/j.ctim.2016.10.009.
    1. Sehhati Shafaei F, Kazemzadeh R, Heshmat R, Amani F. Effect of acupressure at Sanyinjiao (SP6)-Hugo (LI4) points on delivery length in nulliparous women: A randomized controlled trial. Iranian J Obstetrics Gynecol Infertility. 2012;15(25):21–28.
    1. Dabiri F, Shahi A. The effect of LI4 acupressure on labor pain intensity and duration of labor: A randomized controlled trial. Oman Med J. 2014;29(6):425–429. doi: 10.5001/omj.2014.113.
    1. Hamidzadeh A, Shahpourian F, Orak RJ, Montazeri AS, Khosravi A. Effects of LI4 acupressure on labor pain in the first stage of labor. J Midwifery Women's Health. 2012;57(2):133–138. doi: 10.1111/j.1542-2011.2011.00138.x.
    1. Sebastian MK. Effect of acupressure on labour pain during first stage of labour among Primi mothers in a selected hospital of Delhi. Nursing J India. 2014;105(3):136–139.
    1. Ozgoli G, Mobarakabadi SS, Heshmat R, Majd HA, Sheikhan Z. Effect of LI4 and BL32 acupressure on labor pain and delivery outcome in the first stage of labor in primiparous women: a randomized controlled trial. Complementary Therapies Med. 2016;29:175–180. doi: 10.1016/j.ctim.2016.10.009.
    1. Betts D, Lennox S. Acupuncture for prebirth treatment: An observational study of its use in midwifery practice. Med Acupuncture. 2006;17(3):16–19.
    1. Mollart LJ, Adam J, Foureur M. Impact of acupressure on onset of labour and labour duration: A systematic review. Women Birth. 2015;28(3):199–206. doi: 10.1016/j.wombi.2015.03.007.
    1. Chung U-L, Hung L-C, Kuo S-C, Huang C-L. Effects of LI4 and BL 67 acupressure on labor pain and uterine contractions in the first stage of labor. J Nurs Res. 2003;11(4):251–260. doi: 10.1097/01.JNR.0000347644.35251.c1.
    1. Yeh Chao Hsing, Chiang Yi Chien, Hoffman Samuel L., Liang Zhan, Klem Mary Lou, Tam Wilson W. S., Chien Lung-Chang, Suen Lorna Kwai-Ping. Efficacy of Auricular Therapy for Pain Management: A Systematic Review and Meta-Analysis. Evidence-Based Complementary and Alternative Medicine. 2014;2014:1–14.
    1. Hunter RF, McDonough SM, Bradbury I, Liddle SD, Walsh DM, Dhamija S, et al. Exercise and auricular acupuncture for chronic low-back pain: A feasibility randomized-controlled trial. Clin J Pain. 2012;28(3):259–267. doi: 10.1097/AJP.0b013e3182274018.
    1. Barker R, Kober A, Hoerauf K, Latzke D, Adel S, Kain ZN, et al. Out-of-hospital auricular acupressure in elder patients with hip fracture: a randomized double-blinded trial. Acad Emerg Med Off J Soc Acad Emerg Med. 2006;13(1):19–23. doi: 10.1197/j.aem.2005.07.014.
    1. Cha NH, Sok SR. Effects of auricular acupressure therapy on primary dysmenorrhea for female high school students in South Korea. J Nurs Scholarship. 2016;48(5):508–516. doi: 10.1111/jnu.12238.
    1. Wang M-C, Hsu M-C, Chien L-W, Kao C-H, Liu C-F. Effects of auricular acupressure on menstrual symptoms and nitric oxide for women with primary dysmenorrhea. J Altern Complement Med. 2009;15(3):235–242. doi: 10.1089/acm.2008.0164.
    1. Yeh ML, Hung YL, Chen HH, Wang YJ. Auricular acupressure for pain relief in adolescents with dysmenorrhea: a placebo-controlled study. J Alternative Complementary Med (New York, NY) 2013;19(4):313–318. doi: 10.1089/acm.2011.0665.
    1. Aquino CI, Nori SL. Complementary therapy in polycystic ovary syndrome. Translational Med. 2014;9:56–65.
    1. Rastegarzade H, Abedi P, Valiani M, Haghighi MH. The effect of auriculotherapy on labor pain intensity in nulliparous women. Anesthesiol Pain. 2015;6(1):54–63.
    1. Mafetoni RR, Shimo AKK. Effects of auriculotherapy on labour pain: a randomized clinical trial. Revista da Escola de Enfermagem da USP. 2016;50:726–732. doi: 10.1590/s0080-623420160000600003.
    1. Salehian T, Safdari F, Pirak A, Kazemian A, Atarodi Z, Navabi-Rrigi S. Effects of acupressure at the Hugo point (LI4) on labor pain and duration of delivery in nulliparous women. J Ilam Univ Med Sci. 2011;18(4):12–19.
    1. Wyrwich KW, Tierney WM, Wolinsky FD. Further evidence supporting an SEM-based criterion for identifying meaningful intra-individual changes in health-related quality of life. J Clin Epidemiol. 1999;52(9):861–873. doi: 10.1016/S0895-4356(99)00071-2.
    1. Oleson T. Auriculotherapy manual: Chinese and western systems of ear acupuncture. China: Elsevier Health Sciences; 2014.
    1. Wang Yajuan. Micro-Acupuncture in Practice. 2009. Micro-Acupuncture Therapeutics; pp. 280–536.
    1. Schlaeger JM, Gabzdyl EM, Bussell JL, Takakura N, Yajima H, Takayama M, et al. Acupuncture and acupressure in labor. J Midwifery Women's Health. 2017;62(1):12–28. doi: 10.1111/jmwh.12545.
    1. Jarmey C, Bouratinos I. A practical guide to acu-points. California: North Atlantic Books; 2008.
    1. Gregson S, Tiran D, Absalom J, Older L, Bassett P. Acupressure for inducing labour for nulliparous women with post-dates pregnancy. Complement Ther Clin Pract. 2015;21(4):257–261. doi: 10.1016/j.ctcp.2015.07.003.
    1. Waters BL, Raisler J. Ice massage for the reduction of labor pain. J Midwifery Women's Health. 2003;48(5):317–321. doi: 10.1016/S1526-9523(03)00277-0.
    1. Lim CED, Wilkinson JM, Wong WSF, Cheng NCL. Effect of acupuncture on induction of labor. J Altern Complement Med. 2009;15(11):1209–1214. doi: 10.1089/acm.2009.0100.
    1. Asadi N, Maharlouei N, Khalili A, Darabi Y, Davoodi S, Shahraki HR, et al. Effects of LI-4 and SP-6 Acupuncture on labor pain, cortisol level and duration of labor. J Acupuncture Meridian Studies. 2015;8(5):249–254. doi: 10.1016/j.jams.2015.08.003.
    1. Smith CA, Crowther CA, Collins CT, Coyle ME. Acupuncture to induce labor: a randomized controlled trial. Obstet Gynecol. 2008;112(5):1067–1074. doi: 10.1097/AOG.0b013e31818b46bb.
    1. Akbarzadeh Marzieh, Masoudi Zahra, Hadianfard Mohammad Javad, Kasraeian Maryam, Zare Najaf. Comparison of the Effects of Maternal Supportive Care and Acupressure (BL32 Acupoint) on Pregnant Women’s Pain Intensity and Delivery Outcome. Journal of Pregnancy. 2014;2014:1–7. doi: 10.1155/2014/129208.
    1. Harper TC, Coeytaux RR, Chen W, Campbell K, Kaufman JS, Moise KJ, Jr, et al. A randomized controlled trial of acupuncture for initiation of labor in nulliparous women. J Matern Fetal Neonatal Med. 2006;19(8):465–470. doi: 10.1080/14767050600730740.
    1. Dong C, Hu L, Liang F, Zhang S. Effects of electro-acupuncture on labor pain management. Arch Gynecol Obstet. 2015;291(3):531–536. doi: 10.1007/s00404-014-3427-x.
    1. Lee MK, Chang SB, Kang D-H. Effects of SP6 acupressure on labor pain and length of delivery time in women during labor. J Alternative Complementary Med. 2004;10(6):959–965. doi: 10.1089/acm.2004.10.959.
    1. Ma W, Bai W, Lin C, Zhou P, Xia L, Zhao C, et al. Effects of Sanyinjiao (SP6) with electroacupuncture on labour pain in women during labour. Complementary Therapies Med. 2011;19:S13–SS8. doi: 10.1016/j.ctim.2010.09.001.
    1. Nesheim B-I, Kinge R, Berg B, Alfredsson B, Allgot E, Hove G, et al. Acupuncture during labor can reduce the use of meperidine: a controlled clinical study. Clin J Pain. 2003;19(3):187–191. doi: 10.1097/00002508-200305000-00006.
    1. Ministry of Health and Medical Education. Health sector evolution. Available from: . 2015. Accessed 19 Dec 2018.
    1. Cunningham G, Leveno JK, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams obstetrics. 24 ed. New York: McGraw-Hill; 2014.
    1. Enjezab B, Khoshbin A, Bokaei M, Naghshin N. Effect of ice massage on Hoku point for reduction of labor pain. J Shahid Sadoughi University Med Sci. 2008;15(4):69–74.
    1. Chan AW, Tetzlaff JM, Altman DG, Laupacis A, Gotzsche PC, Krleza-Jeric K, et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158(3):200–207. doi: 10.7326/0003-4819-158-3-201302050-00583.

Source: PubMed

Sponsorzy i współpracownicy

Warunki medyczne

Interwencje lekowe

3
Subskrybuj