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.

• Authors: Yao Chen, Xiang-Yin Xiang, Kien Howe Robert Chin, Jing Gao, Junmei Wu, Lixing Lao, Haiyong Chen
• Journal: Acupuncture in medicine : journal of the British Medical Acupuncture Society (Acupunct Med) Vol. 39 Issue 4 Pg. 243-252 (08 2021) ISSN: 1759-9873 [Electronic] England
• PMID: 32811182 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)

Chemical References

• Analgesics

Topics

• Acupuncture Analgesia
• Adult
• Analgesics (administration & dosage)
• Female
• Humans
• Labor Pain (drug therapy, therapy)
• Pregnancy
• Randomized Controlled Trials as Topic
• Treatment Outcome