Perineal Pain Relief Therapies After Postpartum

Abstract

Objective: identifying therapies for treating perineal pain after vaginal birth and to verify indication, technique and duration of local cooling.Method: an exploratory study (survey) conducted in 32 public maternity hospitals in the city of São Paulo (Brazil). A nurse or midwife who provided direct care to the woman was interviewed in each maternity ward. We investigated: institutional characterization, professional qualification, pain relief method, criterion for administration of therapies, indication, contraindication, method, local cooling technique and interval. A descriptive analysis was also carried out.Results: pharmacological and non-pharmacological methods were used for perineal pain relief, despite the use of non-pharmacological therapies not having protocols in these institutions. Among the pharmacological-based methods, analgesics and anti-inflammatories were the most common. Local cooling was the most used non-pharmacological method, and its main indication was perineal edema. Application time and local cooling interval ranged from 10-30 min and 3-8 h, respectively. Ice cubes in latex gloves were the main cooling technique.Conclusion: drug therapies predominated for control of perineal pain. Considering the advantages of non-pharmacological therapies, it is necessary to develop protocols to ensure their safe and effective use in maternity care. DESCRIPTORS:Cryotherapy. Perineum. Postpartum period. Pain. Maternal-child nursing. TERAPIAS DE ALÍVIO DA DOR PERINEAL NO PÓS-PARTO RESUMOObjetivo: identificar as terapias para tratamento da dor perineal pós-parto normal e verificar indicação, técnica e duração da crioterapia.Método: estudo exploratório (survey) conduzido em 32 maternidades públicas do município de São Paulo (Brasil). Em cada maternidade, entrevistou-se uma enfermeira ou obstetriz que prestasse assistência direta à puérpera. Investigaram-se: caracterização institucional, qualificação profissional, método de alívio da dor, critério de administração das terapias, indicação, contraindicação, modalidade, técnica e intervalo da crioterapia. Realizou-se análise descritiva.Resultados: métodos medicamentosos e não medicamentosos foram utilizados no alívio da dor perineal, apesar do uso das terapias não medicamentosas não estar protocolado nessas instituições. Entre os métodos medicamentosos destacaram-se os analgésicos e antiinflamatórios. A crioterapia foi o método não medicamentoso mais utilizado, sendo sua principal indicação o edema perineal. Tempo de aplicação e intervalo da crioterapia variaram 10-30min e 3-8h, respectivamente. Cubos de gelo em luva de látex foi a principal técnica de resfriamento.Conclusão: as terapias medicamentosas predominaram no controle da dor perineal. Considerando as vantagens das terapias não medicamentosas, faz-se necessário desenvolver protocolos para garantir seu emprego seguro e eficaz na assistência obstétrica. DESCRITORES: TERAPIAS DE ALIVIO DEL DOLOR PERINEAL EN EL POSTPARTO RESUMENObjetivo: identificar las terapias para el tratamiento del dolor perin...

Perineal Care and Outcomes in a Birth Center

“…22 However, even though these side effects may occur, medicines are predominant for pain relief. 23 On the other hand, the medicine overuse can be managed with the use of non-pharmacological methods for pain relief. 3 In this study, natural perineal care methods were used in a little more than half of women.…”

Effect of Acupressure Applied To Bl23 Point versus Crushed Ice Application on Postpartum Perineal Pain Intensity

“…Whilst pharmacological pain relief may be effective, its side effects sometimes outweigh their benefits especially among breastfeeding mothers so, recently the move is toward testing safe and effective nonpharmacological pain relieving measures (Smith et al, 2022). These measures include transcutaneous electrical nerve stimulation, acupuncture, local cooling (cryotherapy) and acupressure (Peleckis et al, 2017& Dutra et al, 2019. It is more effective to apply more than one intervention for more pain control to act on the different aspects of pain, so the current study investigated the effect of crushed ice pack application versus BL23 point acupressure on postpartum perineal pain intensity.…”