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Erschienen in: Archives of Gynecology and Obstetrics 2/2020

27.01.2020 | Maternal-Fetal Medicine

The effect of acupressure applied to points LV4 and LI4 on perceived acute postpartum perineal pain after vaginal birth with episiotomy: a randomized controlled study

verfasst von: Ayça Şolt Kirca, Derya Kanza Gul

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 2/2020

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Abstract

Purpose

Acupressure can be used for alleviating perineal pain sustained after a vaginal birth with episiotomy. To evaluate if a 10-min acupressure application relieved perineal pain after vaginal birth with episiotomy and if the analgesic effect was maintained for up to 120 min.

Methods

A randomized controlled trial was conducted from January to May 2019 with 120 women. The participants were over 18 years old, had an episiotomy and experienced perineal pain ≥ 4, had not received anti-inflammatory medication or analgesics after childbirth, and were randomized to receive acupressure or ice-pack application on the perineum for 10 min or standard care.

Results

Immediately post-intervention, the women in the experimental groups had a significantly higher decrease in perineal pain. Within 120 min, there was a significant difference in the pain levels between the three groups. Each method (acupressure, ice package and control group) is evaluated for 30 min (VAS 3), 60 min (VAS 4) and 120 min (VAS 5). Comparing these 3 methods the acupressure has significantly reduced pain after the application (VAS 3 3.20 ± 1.28 vs. 3.77 ± 1.27 vs. 4.82 ± 0.93, respectively, VAS 4 2.65 ± 1.33 vs. 3.5 ± 1.37 vs. 4.62 ± 0.97, respectively, VAS 5 2.02 ± 1.44 vs. 3.5 ± 1.37 vs. 4.57 ± 0.93, respectively, p < 0.05)

Conclusion

Effective pain relief is achieved by applying acupressure for 10 min to the perineum and is maintained between 30, 60, and 120 min.
Literatur
2.
Zurück zum Zitat Akbarzade M, Ghaemmaghami M, Yazdanpanahi Z, Zare N, Mohagheghzadeh A, Azizi A (2016) Comparison of the effect of dry cupping therapy and acupressure at BL23 point on intensity of postpartum perineal pain based on the short form of McGill Pain Questionnaire. J Reprod Infertil 17(1):39PubMedPubMedCentral Akbarzade M, Ghaemmaghami M, Yazdanpanahi Z, Zare N, Mohagheghzadeh A, Azizi A (2016) Comparison of the effect of dry cupping therapy and acupressure at BL23 point on intensity of postpartum perineal pain based on the short form of McGill Pain Questionnaire. J Reprod Infertil 17(1):39PubMedPubMedCentral
3.
Zurück zum Zitat Kwan WS, Li WW (2014) Effect of ear acupressure on acute postpartum perineal pain: a randomised controlled study. J Clin Nurs 23(7–8):1153–1164CrossRefPubMed Kwan WS, Li WW (2014) Effect of ear acupressure on acute postpartum perineal pain: a randomised controlled study. J Clin Nurs 23(7–8):1153–1164CrossRefPubMed
5.
Zurück zum Zitat Marra C, Pozzi I, Ceppi L, Sicuri M, Veneziano F, Regalia AL (2011) Wrist–ankle acupuncture as perineal pain relief after mediolateral episiotomy: a pilot study. J Altern Complement Med 17(3):239–241CrossRefPubMed Marra C, Pozzi I, Ceppi L, Sicuri M, Veneziano F, Regalia AL (2011) Wrist–ankle acupuncture as perineal pain relief after mediolateral episiotomy: a pilot study. J Altern Complement Med 17(3):239–241CrossRefPubMed
6.
Zurück zum Zitat Karacam Z, Eroglu K (2003) Effects of episiotomy on bonding and mother’s health. J Adv Nur 43:384–394CrossRef Karacam Z, Eroglu K (2003) Effects of episiotomy on bonding and mother’s health. J Adv Nur 43:384–394CrossRef
7.
Zurück zum Zitat Şenol DK, Aslan Eti F (2016) Vajinal doğum sonrası perineal soğuk uygulamanın fiziksel aktivitelere etkisi. Florence Nightingale Hemşire Derg 24(3):133–142 Şenol DK, Aslan Eti F (2016) Vajinal doğum sonrası perineal soğuk uygulamanın fiziksel aktivitelere etkisi. Florence Nightingale Hemşire Derg 24(3):133–142
8.
Zurück zum Zitat Amorim-Francisco A, Vasconcellos J, de Oliveira SM, Barbosa da Silva FM, Bick D, Gonzalez Riesco ML (2010) Women’s experiences of perineal pain during the immediate postnatal period: a cross-sectional study in Brazil. Midwifery 27(6):e254–e259CrossRefPubMed Amorim-Francisco A, Vasconcellos J, de Oliveira SM, Barbosa da Silva FM, Bick D, Gonzalez Riesco ML (2010) Women’s experiences of perineal pain during the immediate postnatal period: a cross-sectional study in Brazil. Midwifery 27(6):e254–e259CrossRefPubMed
9.
Zurück zum Zitat East CE, Sherburn M, Nagle C, Said J, Forster D (2012) Perineal pain following childbirth: prevalence, effects on postnatal recovery and analgesia usage. Midwifery 28(1):93–97CrossRefPubMed East CE, Sherburn M, Nagle C, Said J, Forster D (2012) Perineal pain following childbirth: prevalence, effects on postnatal recovery and analgesia usage. Midwifery 28(1):93–97CrossRefPubMed
11.
Zurück zum Zitat Kettle C, Tohill S (2008) Perineal care. BMJ Clin Evidence1401 Kettle C, Tohill S (2008) Perineal care. BMJ Clin Evidence1401
12.
Zurück zum Zitat Macarthur AJ, Macarthur C (2004) Incidence, severity, and determinants of perineal pain after vaginal delivery: a prospective cohort study. Am J Obstet Gynecol 191(4):1199–1204CrossRefPubMed Macarthur AJ, Macarthur C (2004) Incidence, severity, and determinants of perineal pain after vaginal delivery: a prospective cohort study. Am J Obstet Gynecol 191(4):1199–1204CrossRefPubMed
13.
Zurück zum Zitat Macleod M, Goyder K, Howarth L, Bahl R, Strachan B, Murphy DJ (2013) Morbidity experienced by women before and after operative vaginal delivery: prospective cohort study nested within a two-centre randomised controlled trial of restrictive versus routine use of episiotomy. Br J Obstet Gynaecol 120(8):1020–1026CrossRef Macleod M, Goyder K, Howarth L, Bahl R, Strachan B, Murphy DJ (2013) Morbidity experienced by women before and after operative vaginal delivery: prospective cohort study nested within a two-centre randomised controlled trial of restrictive versus routine use of episiotomy. Br J Obstet Gynaecol 120(8):1020–1026CrossRef
14.
Zurück zum Zitat Erbaba H, Pınar G (2016) Postpartum Perineal Travmanın Önlenmesi ve Yönetimine İlişkin Güncel Yaklaşımlar. Koç Üniversitesi Hemşirelikte Eğitim ve Araştırma Dergisi (HEAD) 13(3):272–281 Erbaba H, Pınar G (2016) Postpartum Perineal Travmanın Önlenmesi ve Yönetimine İlişkin Güncel Yaklaşımlar. Koç Üniversitesi Hemşirelikte Eğitim ve Araştırma Dergisi (HEAD) 13(3):272–281
16.
Zurück zum Zitat Francisco AA, De Oliveira SMJV, Steen M, Nobre MRC, De Souza EV (2018) Ice pack induced perineal analgesia after spontaneous vaginal birth: randomized controlled trial. Women Birth 31(5):e334–340CrossRefPubMed Francisco AA, De Oliveira SMJV, Steen M, Nobre MRC, De Souza EV (2018) Ice pack induced perineal analgesia after spontaneous vaginal birth: randomized controlled trial. Women Birth 31(5):e334–340CrossRefPubMed
17.
Zurück zum Zitat Hamlacı Y, Yazici S (2017) The effect of acupressure applied to point LI4 on perceived labor pains. Holist Nurs Pract 31(3):167–176CrossRefPubMed Hamlacı Y, Yazici S (2017) The effect of acupressure applied to point LI4 on perceived labor pains. Holist Nurs Pract 31(3):167–176CrossRefPubMed
18.
Zurück zum Zitat Bleakley CM, McDonough SM, MacAuley DC, Bjordal J (2006) Cryotherapy for acute ankle sprains: a randomised controlled study of two different icing protocols. Br J Sports Med 40(8):700–705CrossRefPubMedPubMedCentral Bleakley CM, McDonough SM, MacAuley DC, Bjordal J (2006) Cryotherapy for acute ankle sprains: a randomised controlled study of two different icing protocols. Br J Sports Med 40(8):700–705CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Knight KL (2000) Cryotherapy in sport injury management. Manole, São Paulo Knight KL (2000) Cryotherapy in sport injury management. Manole, São Paulo
20.
Zurück zum Zitat Navvabi S, Abedian Z, Steen-Greaves M (2009) Effectiveness of cooling gel pads and ice packs on perineal pain. Br J Midwifery 17(11):724–729CrossRef Navvabi S, Abedian Z, Steen-Greaves M (2009) Effectiveness of cooling gel pads and ice packs on perineal pain. Br J Midwifery 17(11):724–729CrossRef
21.
Zurück zum Zitat Oliveira SMJV, Silva FMB, Riesco MLG, Latorre MR, Nobre MRC (2012) Comparison of application times for ice packs used to relieve perineal pain after normal birth: randomised clinical trial. J Clin Nurs 21(23–24):3382–3391CrossRefPubMed Oliveira SMJV, Silva FMB, Riesco MLG, Latorre MR, Nobre MRC (2012) Comparison of application times for ice packs used to relieve perineal pain after normal birth: randomised clinical trial. J Clin Nurs 21(23–24):3382–3391CrossRefPubMed
22.
Zurück zum Zitat Dibble SL, Chapman J, Mack KA, Shih AS (2000) Acupressure for nausea: results of a pilot study. Oncol Nurs Forum 27(1):41–47PubMed Dibble SL, Chapman J, Mack KA, Shih AS (2000) Acupressure for nausea: results of a pilot study. Oncol Nurs Forum 27(1):41–47PubMed
23.
Zurück zum Zitat Gao D (1997) The encyclopedia of Chinese medicine. Carlton Books, Spain Gao D (1997) The encyclopedia of Chinese medicine. Carlton Books, Spain
24.
Zurück zum Zitat Mirbagher-Ajorpaz N, Adib-Hajbaghery M, Mosaebi F (2011) The effects of acupressure on primary dysmenorrhea: a randomized controlled trial. Complement Ther Clin Pract 17(1):33–36CrossRefPubMed Mirbagher-Ajorpaz N, Adib-Hajbaghery M, Mosaebi F (2011) The effects of acupressure on primary dysmenorrhea: a randomized controlled trial. Complement Ther Clin Pract 17(1):33–36CrossRefPubMed
25.
Zurück zum Zitat Schlaeger JM, Gabzdyl EM, Bussell JL, Takakura N, Yajima H, Takayama M, Wilkie DJ (2017) Acupuncture and acupressure in labor. J Midwifery Women's Health 62(1):12–28CrossRef Schlaeger JM, Gabzdyl EM, Bussell JL, Takakura N, Yajima H, Takayama M, Wilkie DJ (2017) Acupuncture and acupressure in labor. J Midwifery Women's Health 62(1):12–28CrossRef
26.
Zurück zum Zitat Liechti E (1998) The complete ıllustrated guide to shıatsu. The Japanese healing art of touch for health and fitness. Element Books, Rockport Liechti E (1998) The complete ıllustrated guide to shıatsu. The Japanese healing art of touch for health and fitness. Element Books, Rockport
27.
Zurück zum Zitat Faul F, Erdfelder E, Buchner A, Lang AG (2009) Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods 41:1149–1160CrossRefPubMed Faul F, Erdfelder E, Buchner A, Lang AG (2009) Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods 41:1149–1160CrossRefPubMed
28.
Zurück zum Zitat Esteban BMM, Calvo JAS, Morcillo CT, Espeja JJD, Hinojosa JG, Goñi ÁZ (2019) Retrospective case review of combined local mepivacaine and steroid injections into vaginal trigger points for the management of moderate-to-severe perineal pain after childbirth. Arch Gynecol Obstet 299(2):501–505CrossRef Esteban BMM, Calvo JAS, Morcillo CT, Espeja JJD, Hinojosa JG, Goñi ÁZ (2019) Retrospective case review of combined local mepivacaine and steroid injections into vaginal trigger points for the management of moderate-to-severe perineal pain after childbirth. Arch Gynecol Obstet 299(2):501–505CrossRef
30.
Zurück zum Zitat Aslan FE, Öztürk KZ (2014) Ağrı ölçümü ve değerlendirilmesi. In: Eti FA (ed) Ağrı Doğası ve Kontrolü. Akademisyen Tıp kitapevleri, Ankara, pp 67–100 Aslan FE, Öztürk KZ (2014) Ağrı ölçümü ve değerlendirilmesi. In: Eti FA (ed) Ağrı Doğası ve Kontrolü. Akademisyen Tıp kitapevleri, Ankara, pp 67–100
31.
Zurück zum Zitat Kömürcü N, Ergin AB (2014) Doğum Ağrısı ve Yönetimi. In: Kömürcü N (ed) Bölüm3: Doğum Ağrısının Değerlendirilmesi., Bölüm4: Doğum Ağrısının (Dalgalarının), 2nd edn. Yönetimi Nobel Tıp Kitabevleri, Istanbul, pp 39–46 Kömürcü N, Ergin AB (2014) Doğum Ağrısı ve Yönetimi. In: Kömürcü N (ed) Bölüm3: Doğum Ağrısının Değerlendirilmesi., Bölüm4: Doğum Ağrısının (Dalgalarının), 2nd edn. Yönetimi Nobel Tıp Kitabevleri, Istanbul, pp 39–46
32.
Zurück zum Zitat Hawker GA, Mian S, Kendzerska T, French M (2011) Measures of adult pain: visual analog scale for pain (VAS pain), numeric rating scale for pain (NRS pain), McGill pain questionnaire (MPQ), short-form McGill pain questionnaire (SF-MPQ), chronic pain grade scale (CPGS), short form-36 bodily pain scale (SF-36 BPS), and measure of intermittent and constant osteoarthritis pain (ICOAP). Arthritis Care Res 63(S11):S240–S252CrossRef Hawker GA, Mian S, Kendzerska T, French M (2011) Measures of adult pain: visual analog scale for pain (VAS pain), numeric rating scale for pain (NRS pain), McGill pain questionnaire (MPQ), short-form McGill pain questionnaire (SF-MPQ), chronic pain grade scale (CPGS), short form-36 bodily pain scale (SF-36 BPS), and measure of intermittent and constant osteoarthritis pain (ICOAP). Arthritis Care Res 63(S11):S240–S252CrossRef
33.
Zurück zum Zitat Chang SR, Chen KH, Lee CN, Shyu MK, Lin MI, Lin WA (2016) Relationships between perineal pain and postpartum depressive symptoms: a prospective cohort study. Int J Nurs Stud 59:68–78CrossRefPubMed Chang SR, Chen KH, Lee CN, Shyu MK, Lin MI, Lin WA (2016) Relationships between perineal pain and postpartum depressive symptoms: a prospective cohort study. Int J Nurs Stud 59:68–78CrossRefPubMed
34.
Zurück zum Zitat Sriwatanakul K, Kelvie W, Lasagna L, Calimlim JF, Weis OF, Mehta G (1983) Studies with different types of visual analog scales for measurement of pain. Clin Pharmacol Ther 34(2):234–239CrossRefPubMed Sriwatanakul K, Kelvie W, Lasagna L, Calimlim JF, Weis OF, Mehta G (1983) Studies with different types of visual analog scales for measurement of pain. Clin Pharmacol Ther 34(2):234–239CrossRefPubMed
35.
Zurück zum Zitat Stephenson NL, Herman J (2000) Pain measurement: a comparison using horizontal and vertical visual analogue scales. Appl Nurs Res 13(3):157–158CrossRefPubMed Stephenson NL, Herman J (2000) Pain measurement: a comparison using horizontal and vertical visual analogue scales. Appl Nurs Res 13(3):157–158CrossRefPubMed
37.
Zurück zum Zitat George D, Mallery M (2010) SPSS for Windows Step by Step: a simple guide and reference, 17.0 update, 10th edn. Pearson, Boston George D, Mallery M (2010) SPSS for Windows Step by Step: a simple guide and reference, 17.0 update, 10th edn. Pearson, Boston
38.
Zurück zum Zitat Mafetoni RR, Shimo AKK (2016) The effects of acupressure on labor pains during child birth: randomized clinical trial. Rev Lat-Am De Enferm Aguts 8:24 Mafetoni RR, Shimo AKK (2016) The effects of acupressure on labor pains during child birth: randomized clinical trial. Rev Lat-Am De Enferm Aguts 8:24
39.
Zurück zum Zitat Torkzahrani S, Mahmoudikohani F, Saatchi K, Sefidkar R, Banaei M (2017) The effect of acupressure on the initiation of labor: a randomized controlled trial. Women Birth 30(1):46–50CrossRefPubMed Torkzahrani S, Mahmoudikohani F, Saatchi K, Sefidkar R, Banaei M (2017) The effect of acupressure on the initiation of labor: a randomized controlled trial. Women Birth 30(1):46–50CrossRefPubMed
40.
Zurück zum Zitat Ozgoli G, Mobarakabadi SS, Heshmat R, Majd HA, Sheikhan Z (2016) 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. Complement Ther Med 29:175–180CrossRefPubMed Ozgoli G, Mobarakabadi SS, Heshmat R, Majd HA, Sheikhan Z (2016) 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. Complement Ther Med 29:175–180CrossRefPubMed
41.
Zurück zum Zitat Hashashemi M, Ghanbari Z, Movahedi M, Rafieian M, Keivani A, Haghollahi F (2018) The effect of Achillea millefolium and Hypericum perforatum ointments on episiotomy wound healing in primiparous women. J Matern-Fetal Neonatal Med 31(1):63–69CrossRef Hashashemi M, Ghanbari Z, Movahedi M, Rafieian M, Keivani A, Haghollahi F (2018) The effect of Achillea millefolium and Hypericum perforatum ointments on episiotomy wound healing in primiparous women. J Matern-Fetal Neonatal Med 31(1):63–69CrossRef
42.
Zurück zum Zitat Moudi Z, Edozahi M, Emami SA, Asili J, Pour MS (2018) Effects of mastic oleoresin on wound healing and episiotomy pain: a mixed methods study. J Ethnopharmacol 214:225–231CrossRefPubMed Moudi Z, Edozahi M, Emami SA, Asili J, Pour MS (2018) Effects of mastic oleoresin on wound healing and episiotomy pain: a mixed methods study. J Ethnopharmacol 214:225–231CrossRefPubMed
43.
Zurück zum Zitat Leventhal LC, de Oliveira SMJV, Nobre MRC, da Silva FMB (2011) Perineal analgesia with an ice pack after spontaneous vaginal birth: a randomized controlled trial. J Midwifery Women’s Health 56(2):141–146CrossRef Leventhal LC, de Oliveira SMJV, Nobre MRC, da Silva FMB (2011) Perineal analgesia with an ice pack after spontaneous vaginal birth: a randomized controlled trial. J Midwifery Women’s Health 56(2):141–146CrossRef
44.
Zurück zum Zitat East CE, Begg L, Henshall NE, Marchant P, Wallace K (2012) Local cooling for relieving pain from perineal trauma sustained during childbirth (review). Cochrane Database Syst Rev 5:1–146 East CE, Begg L, Henshall NE, Marchant P, Wallace K (2012) Local cooling for relieving pain from perineal trauma sustained during childbirth (review). Cochrane Database Syst Rev 5:1–146
45.
Zurück zum Zitat Paiva CSB, de Oliveria SMJV, Francisco AA (2015) Length of perineal pain relief after ice pack application: a quasi experimental study. Women Birth 29(2):117–122CrossRef Paiva CSB, de Oliveria SMJV, Francisco AA (2015) Length of perineal pain relief after ice pack application: a quasi experimental study. Women Birth 29(2):117–122CrossRef
46.
Zurück zum Zitat Tsay SL, Chen ML (2003) Acupressure and quality of sleep in patients with end-stage renal disease: a randomized controlled trial. Int J Nurs Stud 40:1–7CrossRefPubMed Tsay SL, Chen ML (2003) Acupressure and quality of sleep in patients with end-stage renal disease: a randomized controlled trial. Int J Nurs Stud 40:1–7CrossRefPubMed
47.
Zurück zum Zitat Tsay SL (2004) Acupressure and fatigue in patients with end-stage renal disease: a randomized controlled trial. Int J Nurs Stud 41:99–106CrossRefPubMed Tsay SL (2004) Acupressure and fatigue in patients with end-stage renal disease: a randomized controlled trial. Int J Nurs Stud 41:99–106CrossRefPubMed
48.
Zurück zum Zitat Shahla G, Shahnaz T, Ali RA, Reza H (2012) The effects of acupressure on severity of primary dysmenorrhea. Patient Prefer Adherence 6:137–142 Shahla G, Shahnaz T, Ali RA, Reza H (2012) The effects of acupressure on severity of primary dysmenorrhea. Patient Prefer Adherence 6:137–142
Metadaten
Titel
The effect of acupressure applied to points LV4 and LI4 on perceived acute postpartum perineal pain after vaginal birth with episiotomy: a randomized controlled study
verfasst von
Ayça Şolt Kirca
Derya Kanza Gul
Publikationsdatum
27.01.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 2/2020
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-020-05439-z

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