Comparison of Effect of Transcutaneous Electrical Nerve Stimulation and Acupressure in Decreasing Labor Pain in Primiparous Women

Document Type : Original Article

Authors

1 M.Sc. of Midwifery, Fatemeh(P.B.U.H) Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.

2 Lecturer of Midwifery, Fatemeh(P.B.U.H) Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.

3 Associate Professor of Physiotherapy, Faculty of Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran.

Abstract

Introduction: Distress of pain during labor may threaten mother and fetus. This distress causes maternal hypertension and hypersecretion of epinephrine and norepinephrin. Pain control strategies consist of pharmacological and non-pharmacological methods. Yet, there is no ideal drug to control anxiety during labor since all the available drugs pass through placenta and cause fetal depression. The aim of this study was comparison of effect of Transcutaneous electrical nerve stimulation (TENS) and acupressure in decreasing labor pain in primiparous women.
Methods: In present quasi-experimental study, 135 primiparous women randomly divided into three groups: acupressure, TENS, and control group. Intervention was begun in cervical dilatation of 3-4 cm on SP6 location for 30 minutes. Pressure in the first group and TENS like acupuncture in the second group were applied. No method was held on the third group. Pain severity was assessed by Visual Analog Scale in four phases in all groups: before intervention in dilatation of 3-4 cm, immediately after intervention, 30 and 60 minutes after intervention.
Results: The immediate, 30, and 60 minutes after intervention pain severity in first two groups was significantly lower than in control group. There was no significant difference between the acupressure and TENS groups before and immediately after intervention, but the labor pain 30 and 60 minutes after intervention was significantly lower in TENS group. (p<0.001)
Conclusion: Both TENS and acupressure methods decreased the pain during the first stage of labor in primiparous women but TENS was more effective.

Keywords


1. Ronsmans C, Holtz S, Stanton C. Socioeconomic differentials rate in cesarean rates in developing countries: a
retrospective analysis. Lancet 2006 Oct 28;368(9546):1516-23.
2. Bonica J, Chadwick H. Labour pain. In: Melzack R, Patrick DW. Textbook of pain. 2nd ed. London:Churchill
Livingstone;1991:884-9.
3. Simkin P. Reducing pain and enhancing progress in labor: a guide to nonpharmacological methods for maternity
care givers. Birth 1995 Sep;22(3):161-71.
4. Gentz BA. Alternative therapies for the management of pain in labor and delivery. Clin Obstet Gynecol 2001
Dec; 44(4):704-32.
5. Stephen J. Robert L. Understanding acupuncture. Edinburgh:Churchill Livingstone;1999:128-46.
6. Lee M K. [Effects of San-Yin-Jiao (SP6) acupressure on labor pain, delivery time in women during labor]
[Article in Korean]. Taehan Kanho Hakhoe Chi 2003 Oct;33(6):753-61.
 
7. Jun EM, Chang S, Kang DH, Kim S. Effects of acupressure on dysmenorrheal and skin temperature changes in
college students: a non-randomized controlled trial. Int J Nurs Stud 2007 Aug;44(6):973-81.
8. Woolf CL. Transcutaneous electrical nerve stimulation (TENS) and vibration. In: Melzack R, Patrick D W.
Textbook of pain. 2nd ed. London:Churchill Livingstone;1991:884-9.
9. Van der Spank JT, Cambier DC, De Paepe HM, Danneels LA, Witvrouw EE, Beerens L. Pain relief in labour by
transcutaneous electrical nerve stimulation. Arch Gynecol Obstet 2000 Nov;264(3):131-6.
10. Peng T, Li XT, Zhou SF, Xiong Y, Kang Y, Cheng HD.Trascutaneous electrical nerve stimulation on ocupoints
relives labor pain: non-randomized controlled study. Chin J Integr Med 2010 Jun;16(3):234-8.
11. Kaplan B, Rabinerson D, Lurie S, Bar J, Krieser UR, Neri A. Transcutaneous electrical nerve stimulation
(TENS) for adjuvant pain–relief during labor and delivery. Int J Gynaecol Obstet 1998 Mar;60(3):251-5.
12. Kurdi M, Firosi M, Ismaili H. [Effect of pressure on point LI4 on the first stage of labor pain in primiparous
women] [Article in Persian]. Hayat 2010;16(3,4):95-101.
13. Chung UL, Hung LC, Kuo SC, Huang CL. Effects of LI4 and BL67 acupressure on labor pain and uterine
contraction in the first stage of labor. J Nurs Res 2003 Dec;11(4):251-60.
14. Pouria Monfared E, Lotfizadeh M, Kiani M. [Electrical simulation (TENS) on labor] [Article in Persian]. J
Shahre Kord Univ Med Sci 2001 Winter;3(4):2-24.
15. Chao AS, Chao A, Wang TH, Chang YC, Peng HH, Chang SD, et al. Pain relief by transcutaneous electrical
nerve stimulation (TENS) on acupuncture points during first stage of labor: a randomized double-blind placebocontrolled
trial. Pain 2007 Feb;127(3):214-20.