Acupuncture with manual and electrical stimulation for labour pain : a longitudinal randomised controlled trial


Autoria(s): Vixner, Linda; Schytt, Erica; Stener-Victorin, Elisabet; Waldenström, Ulla; Pettersson, Hans; Mårtensson, Lena B.
Data(s)

2014

Resumo

Background: Acupuncture is commonly used to reduce pain during labour despite contradictory results. The aim of this study is to evaluate the effectiveness of acupuncture with manual stimulation and acupuncture with combined manual and electrical stimulation (electro-acupuncture) compared with standard care in reducing labour pain. Our hypothesis was that both acupuncture stimulation techniques were more effective than standard care, and that electro-acupuncture was most effective.  Methods: A longitudinal randomised controlled trial. The recruitment of participants took place at the admission to the labour ward between November 2008 and October 2011 at two Swedish hospitals. 303 nulliparous women with normal pregnancies were randomised to: 40 minutes of manual acupuncture (MA), electro-acupuncture (EA), or standard care without acupuncture (SC). Primary outcome: labour pain, assessed by Visual Analogue Scale (VAS). Secondary outcomes: relaxation, use of obstetric pain relief during labour and post-partum assessments of labour pain. The sample size calculation was based on the primary outcome and a difference of 15 mm on VAS was regarded as clinically relevant, this gave 101 in each group, including a total of 303 women.  Results: Mean estimated pain scores on VAS (SC: 69.0, MA: 66.4 and EA: 68.5), adjusted for: treatment, age, education, and time from baseline, with no interactions did not differ between the groups (SC vs MA: mean difference 2.6, 95% confidence interval [CI] -1.7-6.9 and SC vs EA: mean difference 0.6 [95% CI] -3.6-4.8). Fewer number of women in the EA group used epidural analgesia (46%) than women in the MA group (61%) and SC group (70%) (EA vs SC: odds ratio [OR] 0.35; [95% CI] 0.19-0.67).  Conclusions: Acupuncture does not reduce women's experience of labour pain, neither with manual stimulation nor with combined manual and electrical stimulation. However, fewer women in the EA group used epidural analgesia thus indicating that the effect of acupuncture with electrical stimulation may be underestimated. These findings were obtained in a context with free access to other forms of pain relief.

Akupunktur som smärtlindring under förlossning

Formato

application/pdf

Identificador

http://urn.kb.se/resolve?urn=urn:nbn:se:du-14316

doi:10.1186/1472-6882-14-187

ISI:000337323400001

Idioma(s)

eng

Publicador

Högskolan Dalarna, Medicinsk vetenskap

Högskolan Dalarna, Omvårdnad

Department of Women’s and Children’s Health, Division of Reproductive Health, Karolinska Institutet, Retzius väg 13A, 171 77 Stockholm, Sweden

Centre for Clinical Research Dalarna, Nissers väg 3, 791 82 Falun, Sweden

Department of Physiology, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, 405 30 Gothenburg, Sweden

Department of Women’s and Children’s Health, Division of Reproductive Health, Karolinska Institutet, Retzius väg 13A, 171 77 Stockholm, Sweden

Department of Clinical Science and Education, Södersjukhuset Karolinska Institutet, Stockholm, Sweden

School of Health and Education, University of Skövde, P.O. Box 408, 541 28 Skövde, Sweden

Relação

BMC Complementary and Alternative Medicine, 1472-6882, 2014, 14,

Direitos

info:eu-repo/semantics/openAccess

Tipo

Article in journal

info:eu-repo/semantics/article

text

Palavras-Chave #Health Sciences #Hälsovetenskaper