ABSTRACT
Background Labour pain ranks consistently among the most severe types of pain that a woman will experience during her lifetime and leads harmful effects on both mother and baby. As a complementary method, auricular acupressure has been used in the pain management for many diseases and many RCTs showed it has a pain-reliving effect in labour. However, no meta-analysis has been conducted to provide systematic evidence for pain relief in labour.
Objectives To perform a systematic review to assess the efficacy of auricular acupressure for labor pain.
Search Strategy PubMed, Cochrane Library, Embase, Web of Science databases, SinoMed, CNKI, WanFang Data and VIP were searched for studies using keywords “auricular acupressure” combined with “labor” and “RCTs.”
Selection Criteria: Eligible criteria included RCTs, full-text studies, English, and Chinese literature, whereas exclusion criteria included incomplete information, duplicated publications, and studies combined with other analgesic methods.
Data Collection and Analysis: The selection of eligible items and assessment of methodological quality were performed independently by two researchers. A meta-analysis was performed to analyze the treatment effects on pain intensity reduction, maternal satisfaction and safety.
Main Results: 17 RCTs were included in this review involving a total of 2574 parturients. Auricular acupressure showed significant efficacy in the reduction of pain intensity and improvement of maternal satisfaction.
Conclusions: Auricular acupressure showed a pain-relieving effect compared with the routine care. Although the evidence is limited and high quality studies are needed.
Funding: Health Talents Project of Shandong Province
Keywords: Labor analgesia ;Auricular Acupressure;
Labour pain ranks consistently among the most severe types of pain that a woman will experience during her lifetime, and 60% of them complained their pain as severe or extremely severe.[1-2]Besides being unpleasant, the sharp pain may lead to harmful effects on both mother and baby such as fetal hypoxia and metabolic acidosis.[3]
Since the introduction of chloroform for labour analgesia in 1847[4], different methods and medications have been used to relieve the pain of labour, including neuraxial analgesia, nitrous oxide and systemic opioids. However, the side effects can also arise from the analgesic process. For example, hypotension occurs during 25% to 85% of spinal or epidural anesthetics, and total spinal anesthesia or local anesthetic toxicity may also occur[5]. Accordingly, the non-pharmacologic techniques like progressive muscle relaxation, breathing, music, mindfulness have been recommended by WHO as complementary methods for pain relief during labour.[6]
Auricular therapy has been used for diagnosis and treatment of diseases for thousands of years in China. It has developed into a distinct treatment system since Dr. P. Nogier discovered the correspondence between the auricle and the internal organs in 1957 He suggested that the distribution of auricular points was shaped like an inverted fetus.[7] Under this theoretical framework, the auricle is divided into dozens of areas corresponding to different organs of the body. We can attach magnetic beads or the seed of cowherb to these special areas to treat different diseases in corresponding organs. For example, in labour analgesia, we can attach the seeds to the corresponding points of uterus and pelvis.
For its remarkable efficacy and simplicity, auricular acupressure has been applied for the treatment of epilepsy, anxiety, obesity, and insomnia.[8] A meta-analysis showed it has positive effects on pain management of several diseases.[9]
Many published clinical studies, including randomized controlled trials (RCTs), have explored auricular acupressure as a treatment option for labour pain, and most reports have shown positive clinical effects. However, to the best of our knowledge, no meta-analysis has been conducted on this topic. In the current review, we assessed the effectiveness of auricular acupressure for labour pain by using a meta-analysis.
Methods
This systematic review and meta-analysis (PROSPERO registration No. CRD42021268033) focused on RCTs involving auricular acupressure interventions for pain relief during labour.