Acupuncture in the management of pain in labor

Skilnand, Else; Fossen, D; Heiberg, Eli

doi:10.1034/j.1600-0412.2002.811008.x

Cited by 92 publications

(60 citation statements)

References 9 publications

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“…15 Participants and settings A total of 2038 participants were involved, ranging from 90 to 607 per study. Four studies recruited only nulliparous women; [16][17][18][19] five studies had both nulliparous and multiparous women; 15,[20][21][22][23] and parity was not mentioned in one study. 24 The majority of the studies included women at more than 37 weeks of gestation.…”

Section: Discussionmentioning

confidence: 99%

“…24 The majority of the studies included women at more than 37 weeks of gestation. All studies were conducted in hospital settings: five in Europe, 15,[20][21][22][23] three in China, [16][17][18] and two in Iran. 19,24 Potentially relevant articles reviewed and retrieved for more detailed evaluation (n = 92) …”

Section: Discussionmentioning

confidence: 99%

“…Minimal acupuncture was defined as superficial needling in places that are not regarded as acupoints, but are mainly used as injection sites, such as buttocks, thighs, and arms. 15,19,24 Outcome measures Seven studies reported labour pain on a 100-mm VAS. [15][16][17][18][19]21,24 Five studies assessed the number of women requiring other pain relief at any time.…”

Section: Types Of Control Groupsmentioning

confidence: 99%

“…A range of comparison groups were used including transcutaneous electrical nerve stimulation (TENS), 18,20 conventional analgesia, 20,22,23 minimal acupuncture at nonacupoints, 15,19,24 EDA, 18 subcutaneous sterile water injection, 21 placebo EA, 16,17 and no intervention. [16][17][18]24 Two studies 16,17 from China employed placebo EA where needle penetrating was simulated, followed by needle fixing on an acupoint with adhesive tapes and connected to an inactive electric device.…”

Section: Types Of Control Groupsmentioning

confidence: 99%

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Acupuncture for pain relief in labour: a systematic review and meta‐analysis

Cho

Lee

Ernst

2010

BJOG

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Background Acupuncture is frequently used for pain relief in labour, but the evidence is not clear.Objectives To critically evaluate the evidence for or against acupuncture for labour pain management.Search strategy Nineteen electronic databases, including English, Korean, Japanese, and Chinese databases, were systematically searched.Selection criteria All randomised controlled trials (RCTs) involving women receiving acupuncture alone, or as an adjunct to conventional analgesia, for pain relief in labour were considered.Data collection and analysis Pain intensity on a 100-mm visual analogue scale (VAS; 0, no pain; 100, worst pain) and use of other analgesic methods were used as primary outcomes, and for statistical pooling. Maternal/fetal outcomes were secondary outcomes, and adverse events were also recorded. Risk of bias was assessed regarding randomisation, allocation concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases.Main results Ten RCTs involving 2038 women were included. VAS for pain intensity data were available in seven studies; the meta-analysis shows that acupuncture was not superior to minimal acupuncture at 1 hour (pooled mean difference )8.02; 95% CI )21.88, 5.84; I 2 = 94%) and at 2 hours ()10.15; 95% CI )23.18, 2.87; I 2 = 92%). Patients reported significantly reduced pain by 4 and 6% during electroacupuncture (EA) treatment at 15 ()4.09; 95% CI )8.05, )0.12) and 30 minutes ()5.94; 95% CI )9.83, )2.06), compared with placebo EA, but the effect was not maintained afterwards. Compared with no intervention, acupuncture reduced pain by only 11% for the first 30 minutes ()10.56; 95% CI )16.08, )5.03). In trials where acupuncture was compared with conventional analgesia, women receiving acupuncture required less meperidine (pooled risk ratio 0.20; 95% CI 0.12, 0.33) and other analgesic methods (0.75; 95% CI 0.66, 0.85). No acupuncture-related adverse events were reported. Most trials did not blind participants, care providers and/or evaluators.Author's conclusions The evidence from RCTs does not support the use of acupuncture for controlling labour pain. The primary studies are diverse and often flawed. Further research seems warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Types Of Control Groupsmentioning

confidence: 99%

Section: Types Of Control Groupsmentioning

confidence: 99%

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Acupuncture for pain relief in labour: a systematic review and meta‐analysis

Cho

Lee

Ernst

2010

BJOG

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“…Acupuncture seems to help women manage labour pain and avoid pharmacological pain relief, though it is still unclear if acupuncture can reduce pain intensity [2,3]. Some studies have found that acupuncture leads to a reduction of pain during labour [4,5], whereas other studies have not [6][7][8][9]. Three studies, however, reported that acupuncture leads to a reduced use of pharmacological pain relief such as epidural analgesia and pethidin [6,7,10].…”

Section: Introductionmentioning

confidence: 91%

Acupuncture with manual and electrical stimulation for labour pain: a two month follow up of recollection of pain and birth experience

Vixner¹,

Mårtensson²,

Schytt³

2016

Deutsche Zeitschrift für Akupunktur

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Background: In a previous randomised controlled trial we showed that acupuncture with a combination of manual-and electrical stimulation (EA) did not affect the level of pain, as compared with acupuncture with manual stimulation (MA) and standard care (SC), but reduced the need for other forms of pain relief, including epidural analgesia. To dismiss an under-treatment of pain in the trial, we did a long-term follow up on the recollection of labour pain and the birth experience comparing acupuncture with manual stimulation, acupuncture with combined electrical and manual stimulation with standard care. Our hypothesis was that despite the lower frequency of use of other pain relief, women who had received EA would make similar retrospective assessments of labour pain and the birth experience 2 months after birth as women who received standard care (SC) or acupuncture with manual stimulation (MA). Methods: Secondary analyses of data collected for a randomised controlled trial conducted at two delivery wards in Sweden. A total of 303 nulliparous women with normal pregnancies were randomised to: 40 min of MA or EA, or SC without acupuncture. Questionnaires were administered the day after partus and 2 months later.

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