مقایسه تأثیر طب فشاری در نقاط LI4 و SP6 بر شدت درد پس از سزارین

نوع مقاله : اصیل پژوهشی

نویسندگان

1 استادیار گروه پرستاری سلامت جامعه، مرکز تحقیقات عوامل اجتماعی مؤثر بر سلامت، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی رفسنجان، رفسنجان، ایران.

2 مربی گروه روان پرستاری و سلامت روان، مرکز تحقیقات عوامل اجتماعی مؤثر بر سلامت، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی رفسنجان، رفسنجان، ایران.

3 مربی گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی رفسنجان، رفسنجان، ایران.

4 دانشجوی کارشناسی ارشد پرستاری داخلی جراحی، مرکز تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی رفسنجان، رفسنجان، ایران.

چکیده

مقدمه: نقاط فشاری LI4 و SP6، رایج‌ترین نقاط برای تسکین درد پس از سزارین در ایران می‌باشند، اما در زمینه نقطه فشاری ارجح، اتفاق نظری وجود ندارد،لذا مطالعه حاضر با هدف مقایسه تأثیر طب فشاری در نقاط LI4 و SP6 بر درد پس از سزارین انجام گرفت.
روش‌کار: این مطالعه کارآزمایی بالینی دوسوکور در سال 1396 بر روی 90 نفر از زنان مراجعه‌کننده به زایشگاه‌های شهر رفسنجان انجام شد. افراد به روش تصادفی در سه گروه مداخله LI4، مداخله SP6 و گروه کنترل قرار گرفتند. مداخله در نقاط فشاری به‌صورت دوطرفه، در دوره‌های 10 ثانیه فشار و 2 ثانیه استراحت به‌مدت 20 دقیقه به‌طور متوالی اعمال گردید. در گروه کنترل، نقاط فوق با الگوی مشابه بدون فشار، لمس می‌شد. شدت درد، قبل، بلافاصله و یک ساعت بعد از مداخله در سه گروه توسط مقیاس آنالوگ دیداری تعیین شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 16) و آزمون‌های ANOVA و آنالیز واریانس برای اندازه‌گیری‌های تکراری انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: در مطالعه حاضرمیانگین نمرات درد در بین سه مرحله اندازه‌گیری متوالی تفاوت آماری معنی‌داری داشت (033/0=p‌)، اما مقایسه میانگین سه نمره درد در هر گروه با گروه‌های دیگر تفاوت معنی‌داری نشان نداد (428/0=p). نتایج نشان‌دهنده روند کاهش نمره درد در گروه مداخله در نقطه Li4 در طول اندازه‌گیری‌های متوالی و همچنین کاهش نمره درد در گروه Li4 در مقایسه با گروه کنترل در زمان یک ساعت پس از مداخله بود (001/0=p).
نتیجه‌گیری: عملکردطب فشاری در نقطه LI4 در تسکین درد سزارین بهتر از نقطه فشاری SP6 می‌باشد.

کلیدواژه‌ها

عنوان مقاله [English]

Comparison of the effect of Acupressure at LI4 and SP6 points on the intensity of Post Cesarean Pain

نویسندگان [English]

  • Tayebeh Negahban Bonabi 1
  • Ali Ansari Jaberi 2
  • Shayesteh Esmaeilzadeh 3
  • Afsaneh Hasanshahi Ravizi 4
1 Assistant professor, Department of Community Health Nursing, Social Determinants of Health Research Center, School of Nursing and Midwifery, Rafsanjan University of Medical sciences, Rafsanjan, Iran.
2 Instructor, Department of Psychiatric and Mental Health Nursing, Social Determinants of Health Research Center, School of Nursing and Midwifery, Rafsanjan University of Medical sciences, Rafsanjan, Iran.
3 Instructor, Department of Midwifery, School of Nursing and Midwifery, Rafsanjan University of Medical sciences, Rafsanjan, Iran.
4 M.Sc. student in Internal Surgery Nursing, Student Research Center, School of Nursing and Midwifery, Rafsanjan University of Medical sciences, Rafsanjan, Iran
چکیده [English]

Introduction The LI4 and SP6 acupressure points are the most common points to relieve post cesarean pain, but there is no consensus on the preferred point of pressure. Therefore, this study was performed with aim to compare the effect of acupressure at LI4 and SP6 points on the intensity of post cesarean pain.
Methods: This double-blind clinical trial study was performed on 90 women referred to the maternity hospitals of Rafsanjan in 2017. They were randomly allocated into three groups: LI4 point, SP6 point and control group. Intervention was performed bilaterally, in 10 seconds of pressure and 2 seconds of rest for 20 minutes sequentially. In the control group, the points were touched with the same pattern without pressure. The intensity of post cesarean pain before, immediately and one hour after intervention was determined by visual analogue Scale in three groups. Data was analyzed by SPSS software (version 16) and ANOVA and repeated measurement variance analysis. P< 0.05 was considered significant.
Results: In this study, the mean score of pain at three times of measurement (the time effect) was significant different (p=0.33), but comparison of the mean of three pain score in each group was not significantly different with other groups (p=0.428). The result showed a decrease in pain score trend in the Li4 group during three time  measurements and a decrease in pain score of in the Li4 group compared to the control group in 1 hour after the intervention (p=0.001).
Conclusion: The acupressure function at the LI4 point in relieving post cesarean pain is better than the SP6 compression point.

کلیدواژه‌ها [English]

  • Acupressure
  • Complementary and Alternative Medicine
  • Pain Relieving
  • Post-cesarean Pain
  • Postpartum Pain

مراجع

  1. Azami-Aghdash S, Ghojazadeh M, Dehdilani N, Mohammadi M. Prevalence and causes of cesarean section in Iran: systematic review and meta-analysis. Iran J Public Health 2014; 43(5):545-55.
  2. Shahraki AD, Jabalameli M, Ghaedi S. Pain relief after cesarean section: oral methadone vs. intramuscular pethidine. J Res Med Sci 2012; 17(2):143.
  3. Betrán AP, Ye J, Moller AB, Zhang J, Gülmezoglu AM, Torloni MR. The increasing trend in caesarean section rates: global, regional and national estimates: 1990-2014. PloS One 2016; 11(2):e0148343.
  4. Demirel I, Ozer AB, Atilgan R, Kavak BS, Unlu S, Bayar MK, et al. Comparison of patient‐controlled analgesia versus continuous infusion of tramadol in post‐cesarean section pain management. J Obstet Gynaecol Res 2014; 40(2):392-8.
  5. Kulo A, Van De Velde M, de Hoon J, Verbesselt R, Devlieger R, Deprest J, et al. Pharmacokinetics of a loading dose of intravenous paracetamol post caesarean delivery. Int J Obstet Anesth 2012; 21(2):125-8.
  6. Gerbershagen HJ, Aduckathil S, van Wijck AJ, Peelen LM, Kalkman CJ, Meissner W. Pain Intensity on the first day after surgerya prospective cohort study comparing 179 surgical procedures. Anesthesiology 2013; 118(4):934-44.
  7. Lee SY, Lee WH, Lee EH, Han KC, Ko YK. The effects of paracetamol, ketorolac, and paracetamol plus morphine on pain control after thyroidectomy. Korean J Pain 2010; 23(2):124-30.
  8. Imani F. Postoperative pain management. Anesth Pain Med 2011; 1(1):6-7.
  9. Karlström A, Engström‐Olofsson R, Norbergh KG, Sjöling M, Hildingsson I. Postoperative pain after cesarean birth affects breastfeeding and infant care. J Obstet Gynecol Neonatal Nurs 2007; 36(5):430-40.
  10. Karlström A, Engström‐Olofsson R, Nystedt A, Sjöling M, Hildingsson I. Women’s postoperative experiences before and after the introduction of spinal opioids in anaesthesia for caesarean section. J Clin Nurs 2010; 19(9‐10):1326-34.
  11. Eisenach JC, Pan PH, Smiley R, Lavand’homme P, Landau R, Houle TT. Severity of acute pain after childbirth, but not type of delivery, predicts persistent pain and postpartum depression. Pain 2008; 140(1):87-94.
  12. Valentine AR, Carvalho B, Lazo TA, Riley ET. Scheduled acetaminophen with as-needed opioids compared to as-needed acetaminophen plus opioids for post-cesarean pain management. Int J Obstet Anesth 2015; 24(3):210-6.
  13. Buvanendran A, Kroin JS. Multimodal analgesia for controlling acute postoperative pain. Curr Opin Anesthesiol 2009; 22(5):588-93.
  14. McDaid C, Maund E, Rice S, Wright K, Jenkins B, Woolacott N. Paracetamol and selective and non-selective non-steroidal anti-inflammatory drugs (NSAIDs) for the reduction of morphine-related side effects after major surgery: a systematic review. Health Technol Assess 2010; 14(17):1-153.
  15. Golmakani N. Complementary and alternative therapies for post-cesarean pain. Avicenna J Phytomed 2015; 5:109.
  16. Wong JY, Carvalho B, Riley ET. Intrathecal morphine 100 and 200μg for post-cesarean delivery analgesia: a trade-off between analgesic efficacy and side effects. Int J Obstet Anesth 2013; 22(1):36-41.
  17. Hadi N, Hanid AA. Lavender essence for post-cesarean pain. Pak J Biol Sci 2011; 14(11):664-7.
  18. Abbaspoor Z, Akbari M, Najar S. Effect of foot and hand massage in post-cesarean section pain control: a randomized control trial. Pain Manag Nurs 2014; 15(1):132-6.
  19. Hajiamini Z, Masoud SN, Ebadi A, Mahboubh A, Matin AA. Comparing the effects of ice massage and acupressure on labor pain reduction. Complement Ther Clin Pract 2012; 18(3):169-72.
  20. Ahn NY, Park HJ. Effects of Korean hand acupressure on opioid-related nausea and vomiting, and pain after caesarean delivery using spinal anaesthesia. Complement Ther Clin Pract 2017; 28:101-7.
  21. Ganji G, Keramat A, Ahmad Shiravani M. Effect of acupressure on labor pain relief: a systematic review of clinical trials. Iran J Obstet Gynecol Infertil 2014; 17(119):8-17. (Persian).
  22. Hamidzadeh A, Shahpourian F, Orak RJ, Montazeri AS, Khosravi A. Effects of LI4 acupressure on labor pain in the first stage of labor. J Midwifery Womens Health 2012; 57(2):133-8.
  23. Hjelmstedt A, Shenoy ST, Stener‐Victorin E, Lekander M, Bhat M, Balakumaran L, et al. Acupressure to reduce labor pain: a randomized controlled trial. Acta Obstet Gynecol Scand 2010; 89(11):1453-9.
  24. Nani D, Maryati S, Rahmaharyanti R. Effect of acupressure therapy point HT 6 and LI 4 on post cesarean sectio’s pain. Int J Res Med Sci 2015; 3(12):S119-22.
  25. Hamlacı Y, Yazici S. The effect of acupressure applied to point LI4 on perceived labor pains. Holist Nurs Pract 2017; 31(3):167-76.
  26. Ramezani S, Hamidzadeh A, Abdollahpour S, Khosravi A. Effects of LI4 acupressure on post-cesarean section pain. Int J Health Stud 2016; 2(2):23-6.
  27. Boz İ, Demir-akgÜn M. the role of acupressure on pain after caesarean section: a systematic literature review: o-0012| Oral| Cesarean Section Dilemma. J Perinatal Med 2017; 45:40.
  28. Kordi M, Tara F, Bahrami HR, Shariati Nejad K. The effect of hand and foot massage on post-cesarean pain and anxiety. J Midwifery Reprod Health 2015; 3(4):465-71.
  29. Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 1983; 17(1):45-56.
  30. Riley JL 3rd, Cruz-Almeida Y, Glover TL, King CD, Goodin BR, Sibille KT, et al. Age and race effects on pain sensitivity and modulation among middle-aged and older adults. J Pain 2014; 15(3):272-82.
  31. Yezierski RP. The effects of age on pain sensitivity: preclinical studies. Pain Med 2012; 13(Suppl 2):S27-36.
  32. Soltani M, Azhari S, Khorsand Vakilzadeh A, Tara F, Mazloum SR. The effect of acupressure on uterine tone and pain after delivery. Iran J Obstet Gynecol Infertil 2017; 20(9):91-100. (Persian).
  33. Nani D, Maryati S, Rahmaharyanti R. Effect of acupressure therapy point HT 6 and LI 4 on post cesarean sectio’s pain. Int J Res Med Sci 2017; 3:119-22.
  34. Anuhgera DE, Kuncoro T, Sumarni S, Mardiyono M, Suwondo A. Effect of combination of hypnobreastfeeding and acupressure on anxiety and wound pain in post-caesarean mothers. Belitung Nurs J 2017; 3(5):525-32.
  35. Lingling W, Xiaohui L, Yuzhu Y, Ke S, Ling W, Wei Y, et al. Effectiveness of acupuncture versus spinal-epidural anesthesia on labor pain: a randomized controlled trial. J Traditional Chin Med 2017; 37(5):629-35.
  36. Dabiri F, Shahi A. The effect of LI4 acupressure on labor pain intensity and duration of labor: a randomized controlled trial. Oman Med J 2014; 29(6):425-9.
  37. Kordi M, Firoozi M, Esmaili H. Effect of LI4 acupressure on labor pain in the first stage of labor in nuliparous women. J Hayat 2011; 16(3):95-101. (Persian).
  38. Wu HC, Liu YC, Ou KL, Chang YH, Hsieh CL, Tsai AH, et al. Effects of acupuncture on post-cesarean section pain. Chin Med J 2009; 122(15):1743-8.
  39. Hjelmstedt A, Shenoy ST, Stener-Victorin E, Waldenström U. Acupressure to reduce labor pain: a randomized controlled trial. Acta Obstet Gynecol 2010; 89(11):1453-9.
  40. El Hamid VA, Obaya HE, Gaafar HM. Effect of acupressure on labor pain and duration of delivery among laboring women attending Cairo University Hospital. Indian J Physiother Occupat Ther 2013; 7(2):71.
  41. Hossain Pour N, Kaviani M, Razeghi M. Comparison of effect of transcutaneous electrical nerve stimulation and acupressure in decreasing labor pain in primiparous women. Iran J Obstet Gynecol Infertil 2012; 15(12):27-33. (Persian).
  42. Moradi Z, Akbarzadeh M, Zare N, Hadian Fard MJ, Jowkar A. Comparative Study of effect of two-staged acupressure at gb-21 and sp-6 points on the labor pain of active phase in nulliparous women. Iran J Obstet Gynecol Infertil 2012; 15(26):21-9. (Persian).
  43. Salehian T, Safdari Dehcheshmaei F, Pirak A, Kazemian A, Atarodi Z, Navabi Righi SD. Comparison of the effect of Hoku Point (LI4) acupressure with that of San-Yin-Jiao (SP6) acupressure on labor pain and the length of delivery time in primiparous women. Sci J Kurdistan Univ Med Sci 2011; 16(1):64-72. (Persian).
مجله زنان، مامایی و نازایی ایران
دوره 21، شماره 6
شهریور 1397
صفحه 9-17

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