Effects of the addition of transcutaneous electrical stimulation to non-pharmacological measures in labor pain: study protocol for a randomized controlled trial

Abstract

Background Labor, although natural and physiological, is a period that can be marked by stress, pain, anxiety, suffering, fear, and anguish for a woman. Thus, non-pharmacological methods that reduce pain during labor are important to allow a better experience without the use of medications. Therefore, the aim of this study is to evaluate the effects of non-pharmacological pain relief methods, added or not to the application of transcutaneous electrical stimulation (TENS), on pain, satisfaction with the childbirth, duration of labor, and newborn conditions. Methods This is a randomized controlled clinical trial, with a non-probabilistic convenience sample, composed of women in the first active stage of labor, admitted to a public institution. The parturients will be divided into 3 groups: group 1 (n = 36) composed of parturients who will have continuous support and will be encouraged to walk, adopting different positions with the use of the Swiss ball and receiving back massage for 30 min; group 2 (n = 36) composed of parturients who will also have continuous support and will be encouraged to walk, adopt different positions using the Swiss ball, and will receive the application of TENS for 30 min; and group 3 (n = 36) composed of parturients who will have continuous support and will be encouraged to walk, adopting different positions with the use of the Swiss ball, and will receive placebo TENS application for 30 min. The outcomes evaluated in the study will be pain intensity assessed by the visual analog scale of pain applied before, immediately after, and 30 min and 1 h after the interventions; Experience and Satisfaction with Childbirth Questionnaire (QESP) applied 12 to 24 h after delivery; and data regarding delivery (type of delivery, total duration of labor, and possible obstetric complications) and neonate (weight, height, possible complications, Apgar score in the first and fifth minutes). Discussion With this research, it is expected to understand the effects of the intervention through TENS electrostimulation added to other non-pharmacological methods for pain management during labor. Trial registration Brazilian Registry of Clinical Trials (REBEC) RBR-68kh6j. Registered on March 17, 2020

Comparisons of nonpharmaceutical analgesia and pharmaceutical analgesia on the labor analgesia effect of parturient women

“…In contrast, various nonpharmacological therapies seem to be safe to minimize pain intensity, increase maternal satisfaction, as well as delay pharmacological analgesics 13,31 . Nonpharmacological approaches of pain relief may be utilized alone or with the multidisciplinary team (e.g., doctors, nursing technicians, and doulas), which depends on the choice of parturient women and the hospital's infrastructure 16 . In our study, the LeBeiEr delivery analgesia instrument was used for nonpharmacological approaches of pain relief in pregnant women, with the findings revealed that the nonpharmaceutical analgesia showed shorten labor duration and less postpartum bleeding volume.…”

Effects of Complex Rehabilitation Program on Reducing Pain and Disability in Patients with Lumbar Disc Protrusion—Is Early Intervention the Best Recommendation?

“…Moreover, TENS provides electrical stimulation through the skin, through sensory stimuli that will carry information to the brain through afferent fibers to the dorsal horn of the Aß medulla. Therefore, there is a blockage of pain impulses to the brain, as this fiber transmits the information faster than the fibers responsible for transmitting the pain through (the gate control theory) [ 48 ].…”

Efficacy of different strategies for reducing labor pain: A Bayesian analysis

“…[6][7][8][9][10] Studies have explored the effects of various strategies, such as epidurals and opioids to reduce labor pain while considering women experiences and views. [11,12] Although empirical evidence indicates that different medical interventions can alleviate the pain that women experience during childbirth, the outcomes have been inconclusive. While some researchers have found that nonpharmacological pain relief techniques can empower women and that natural remedies may not be as effective as anticipated.…”

“…Studies have explored the effects of various strategies, such as epidurals and opioids to reduce labor pain while considering women experiences and views. [ 11 , 12 ]…”