مقایسه تأثیر طب فشاری و لمس بر سردردهای ناشی از بی حسی اسپاینال پس از سزارین

نوع مقاله: اصیل پژوهشی

نویسندگان

1 استادیار گروه پرستاری داخلی جراحی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایران، تهران، ایران.

2 پزشک طب سوزنی، انجمن علمی طب سوزنی ایران، تهران، ایران.

3 استادیار مرکز تحقیقات خونریزی‌های غیرطبیعی رحم، دانشگاه علوم پزشکی سمنان، سمنان، ایران.

4 مربی گروه آمار، دانشکده بهداشت، دانشگاه علوم پزشکی ایران، تهران، ایران.

5 دانشجوی کارشناسی ارشد پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایران، تهران، ایران.

چکیده

مقدمه: سردرد پس از سوراخ شدن سخت شامه یکی از مشکلات شایع بی‌حسی نخاعی به ویژه در زنان تحت عمل جراحی سزارین است. بهتر است برای درمان اینگونه سردردها از روش‌های غیر دارویی استفاده شود. یکی از روش‌های کنترل غیر دارویی درد، استفاده از طب‌فشاری است، اما تاکنون تأثیر آن بر سردردهای پس از بی‌حسی اسپاینال بررسی نشده است. لذا مطالعه حاضر با هدف بررسی تأثیر طب‌فشاری و لمس بر سردردهای ناشی از بی‌حسی اسپاینال در زنان تحت سزارین انجام شد.
روش کار: این مطالعه کارآزمایی بالینی تصادفی شده با گروه کنترل در سال 1394 بر روی 90 نفر از زنانی که برای بی‌حس کردن آن‌ها جهت عمل سزارین از روش بی‌حسی نخاعی نوع اسپاینال استفاده شده بود، در بیمارستان امیرالمومنین (ع) سمنان انجام شد. بیماران به طور تصادفی به گروه‌های طب‌فشاری، لمس و کنترل تقسیم شدند. شدت درد با استفاده از مقیاس اندازه‌گیری بصری شدت درد سنجیده شد. سپس تغییرات شدت درد قبل و بعد از مداخله اندازه‌گیری و ثبت گردید. تجزیه و تحلیل داده‌ها با استفاده از نرم افزار آماری SPSS (نسخه 16) و آزمون‌های ضریب همبستگی پیرسون و اسپیرمن، کروسکال‌والیس، تی زوجی و آنووا انجام شد. میزان p کمتر از 01/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: میانگین نمره سردرد پس از بی‌حسی نخاعی قبل از مداخله در گروه کنترل 47/1±43/4، در گروه لمس 65/1±48/4 و در گروه طب فشاری 72/1±73/4 بود که تفاوت آماری معنی‌داری بین میانگین نمرات سردرد سه گروه مشاهده نشد (05/0<p).پس از مداخله، میانگین نمرات سردرد در گروه طب‌فشاری و لمس نسبت به گروه کنترل به طور معنی‌داری کاهش یافت (001/0>p). همچنین پس از مداخله، میانگین نمرات سردرد گروه‌ طب‌فشاری در مقایسه با گروه لمس به طور معنی‌داری کاهش یافت (001/0>p).
نتیجه‌گیری: طب‌فشاری در مقایسه با لمس، تأثیر بیشتری در کاهش شدت سردرد ناشی از بی‌حسی اسپاینال در زنان تحت عمل جراحی سزارین دارد. بنابراین پیشنهاد می‌شود از طب‌فشاری در کنار سایر درمان‌های مرسوم جهت کنترل و درمان اینگونه سردردها استفاده شود.

کلیدواژه‌ها


عنوان مقاله [English]

Comparison of the effects of acupressure and touch on the headache caused by spinal anesthesia after cesarean section

نویسندگان [English]

  • Alice Khachian 1
  • Kiarash Saatchi 2
  • Shahrzad Aghaamoo 3
  • Hamid Haghani 4
  • Maedeh Tourdeh 5
1 Assistant professor, Department of Surgery Internal Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
2 Acupuncturist, Iran Acupuncture Scientific Association, Tehran, Iran.
3 Assistant professor, Abnormal Uterine Bleeding Research Center, Semnan University of Medical Sciences, Semnan, Iran.
4 Instructor, Department of Statistics, School of Health, Iran University of Medical Sciences, Tehran, Iran.
5 M.Sc. Student of Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Post-Dural puncture headache (PDPH) is one of the common complications of spinal anesthesia, especially after cesarean section. It is better to treat this headache by non-pharmaceutical methods. One of the non-pharmaceutical pain control methods is the use of acupressure. But so far, its impact on headache after spinal anesthesia has not been studied. Therefore, this study was performed with aim to evaluate the effect of acupressure and touch on headache caused by spinal anesthesia after cesarean section.
Methods: This randomized clinical trial with control group was conducted on 90 patients who underwent cesarean section by spinal anesthesia in Semnan Amir AlMomenin (A) Hospital in 2015. These patients were randomly divided into acupressure, touch and control groups. Pain severity was measured by Visual Analog Scale (VAS). Then, changes of pain severity pre and post intervention was measured and recorded. Data was analyzed by SPSS software (version 16) and Pearson and Spearman correlation coefficient tests, Kruskal-Wallis test, ANOVA and paired t-test. PResults: The mean of pre-intervention PDHP scores in the control, touch and acupressure groups were 4.43±1.47, 4.48±1.65 and 4.73±1.72, respectively that no statistically significant difference was observed between three groups in terms of mean of pre-intervention PDHP scores (P˃0.05). After the intervention, there was a statistically significant decrease in mean pain score in acupressure and touch groups in comparison with control group (P˂0.001). Also, after intervention, there was a statistically significant decrease in mean of headache scores in the acupressure group compared with touch group (P˂0.001).
Conclusion: Comparing with touch, acupressure was more effective for headache-relieving after spinal anesthesia in women undergoing cesarean section. Therefore, it is suggested that acupressure along with other conventional treatments be used to control and treat such headaches

کلیدواژه‌ها [English]

  • Acupressure
  • Cesarean section
  • Headache
  • Spinal anesthesia
  • Touch
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