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.