Acupressure for labor pain management: a systematic review and meta-analysis of randomized controlled trials

Abstract

Objective: To evaluate the efficacy/effectiveness of acupressure as an adjunct to standard procedures during labor and delivery, compared with standard procedures with/without sham acupressure, in randomized controlled trials (RCTs). Methods: Ten main databases were searched from their inception until 31 January 2018. Two reviewers independently extracted data concerning the effects of acupressure on pain intensity, labor duration, mode of delivery, use of medications and adverse events. A meta-analysis of these measures was performed using RevMan 5.3. Pooled standardized mean differences (SMDs) or odds ratios (ORs) for the above outcomes were estimated with a fixed or random effects model, according to the heterogeneity. Results: A total of 13 RCTs including 1586 enrolled patients met the eligibility criteria. Acupressure plus standard procedures (ASP) for labor management significantly reduced pain sensation, compared with sham acupressure plus standard procedures (SASP) and standard procedures (SP) alone. The analgesic effect of acupressure was immediate and persisted for at least 60 min (all p < 0.01). Compared with the untreated control groups, the acupressure group had a shorter duration of labor, especially the first stage of labor (SMD = −0.76, 95% confidence interval (CI) = −1.10 to −0.43; p < 0.001; I2 = 74%) and second stage of labor (SMD = −0.37, 95% CI = −0.59 to −0.18; p < 0.001; I2 = 0%). Data suggesting that acupressure reduced the Cesarean section rate was inconclusive. The use of pharmacologic agents (oxytocin and analgesics) did not differ between the ASP, SASP and SP groups. No adverse events were reported in this limited number of studies. Conclusion: Moderate evidence indicates that acupressure may have promising effects on labor pain and duration. However, high-quality trials to verify these findings are warranted.

Acupressure for Managing Osteoarthritis: A Systematic Review and Meta-Analysis

“…Acupressure has been used for various purposes. Previous systematic reviews have investigated the efficacy or the impact of acupressure as a sole intervention on pain [11], low back pain [10,12], labor or labor pain [13][14][15], neck pain syndrome [16], sleep quality, or sleep disorders [17][18][19], promoting the health of older adults [20], respiratory allergic diseases [21], postoperative gastrointestinal symptoms [22], chemotherapy-induced nausea and vomiting [23], primary dysmenorrhea [24][25][26], anxiety [27], neurological disorders [28], and symptom management [29][30][31]; and other reviews considered acupressure as a complementary intervention with acupuncture on cancer pain [32], cancer-related fatigue [33], weight reduction [34], uremic pruritus [35], premenstrual syndrome [36], and labor pain [37].…”

Factors influencing the use of epidural labor analgesia: a cross-sectional survey analysis

“…Various nonpharmacologic methods for pain alleviation during labor have become popular over the years, either as a complement to pharmacologic agents or at times as the principal therapy. Methods such as relaxation techniques (Lamaze breathing, yoga, hypnosis, and music) ( 33 ), manual techniques (massage, reflexology, and shiatsu) ( 34 ), acupuncture ( 35 , 36 ), birthing ball ( 37 ), transcutaneous electrical nerve stimulation ( 38 ), and emotional support (doula) ( 39 , 40 ), are considered safe, although the evidence supporting their effectiveness for pain relief is not as robust as it is for pharmacologic agents.…”

Pengaruh Metode Akupresur terhadap Lamanya Persalinan: A Systematic Review

“…Sebuah meta-analisis menunjukkan bahwa akupresur secara signifikan dapat mengurangi nyeri persalinan selama fase aktif persalinan dibandingkan dengan non-intervensi. akupresur mungkin memiliki efek yang menjanjikan pada nyeri dan durasi persalinan (18)(19)(20) .…”