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

مراجع

  1. Caningham FG, Leveno KJ, Bloom SL, Spong CH, Dashe JS, Hoffman BL, et al. Williams obstetrics & gynecology. 23th ed. New York: McGraw-Hill; 2010.
  2. Patel N. Anesthesia for cesarean delivery. J Adv Med Dent Sci Res 2015; 3(4):25-9.
  3. Dyer RA, Piercy JL, Reed AR, Lombard CJ, Schoeman LK, James MF. Haemodynamic changes associated with spinal anesthesia for cesarean section in severe preeclampsia. Anethesiology 2008; 108(5):802-11.
  4. Afolabi BB, Lesi FE, Merah NA. Regional veasus general anesthesia for cesarean section. Cochrane Database Syst Rev 2006; 4:CD004350.
  5. Miller RD, Pardo M. Basics of anesthesia. 6th ed. New York: Elsevier Health Sciences; 2011.
  6. Adams HA, Meyer P, Stoppa A, Müller-Goch A, Bayer P, Hecker H. Anesthesia for cesarean section. Comparison of two general anaesthetic regimens and spinal anaesthesia. Anaesthesist 2003; 52(1):23-32.
  7. Eltzschig HK, Lieberman ES, Camann WR. Regional anesthesia and analgesia for labor and delivery. N Engl J Med 2003; 348(4):319-32.
  8. Madineh H, Abedinzadeh M, Ghaheri H. Comparison of post cesarean section pain with general and spinal anesthesia. Shahrekord Univ Med Sci J 2005; 6(4):43-50. (Persian).
  9. Sachs A, Smiley R. Post-dural puncture headache: the worst common complication in obstetric anesthesia. Semin Perinatol 2014; 38(6):386-94.
  10. Alama MR, Raheen MR, Iqbal KM, Chowdhury MR. Headache following spinal anaesthesia: a review on recent update. J Bangladesh Coll Physi Surg 2011; 29(1):32-40.
  11. Turnbull DK, Shepherd DB. Post-dural puncture headache: pathogenesis, prevention and treatment. Br J Anesth 2003; 91(5):718-29.
  12. Brown DL. Spinal, epidural and caudal anesthesia. In: Miller RD, editor. Miller's anesthesia. Philadelphia: Churchill Livingstone; 2010.
  13. Jabbari A, Alijanpour E, Mir M, Bani Hashem N, Rabiea SM, Rupani MA. Post spinal puncture headache, an old problem and new concepts: review of articles about predisposing factors. Caspian J Intern Med 2013; 4(1):595-602.
  14. Mosaffa F, Karimi K, Madadi F, Khoshnevis SH, Daftari Besheli L, Eajazi A. Post-dural puncture headache: a comparison between median and paramedian approaches in orthopedic patients. Anesth Pain Med 2011; 1(2):66-9.
  15. Doroudian MR, Norouzi M, Esmailie M, Tanhaeivash R. Dexamethasone in preventing post-dural puncture headache: a randomized, double-blind, placebo-controlled trial. Acta Anaesthesiol Belg 2011; 62(3):143-6.
  16. Gyanesh P, K R, Sinha M, Haldar R. Postdural puncture headache after caesarean section: are preventive strategies worse than the cure? Rev Bras Anestesiol 2015; 56(1):82-3.
  17. Pirbudak L, Uğur MG, Kaya Uğur B, Kul S, Ganidağlı S. Evaluation of affecting factors and the effectiveness of treatment in cases with post-dural puncture headache who underwent epidural blood patch. Agri 2014; 26(3):101-6.
  18. Manuchehrian N, Arjomandi M, Bakhshaeu MH, Hajian P, Alipur N, Farhanchi A. Efficacy of prophylactic intravenous dexamethasone in prevention of headache strikes due to spinal anesthesia in cesarean sections compared to the control group. J Ilam Univ Med Sci 2012; 19(4):1-11. (Persian).
  19. VahabiS, Nadri S, Izadi F. The effects of gabapentin on severity of post spinal anesthesia headache. Pak J Pharm Sci 2014; 27(5):1203-7.
  20. Huseyinoglu U, Huseyinoglu N, Hamurtekin E, Aygun H, Sulu B. Effect of pregabalin on post-dural-puncture headache following spinal anesthesia and lumbar puncture. J Clin Neurosci 2011; 18(10):1365–8.
  21. Fattahi Z, Hadavi SM, Sahmeddini MA. Effect of ondansetron on post-dural puncture headache (PDPH) in parturients undergoing cesarean section: a double-blind randomized placebo-controlled study. J Anesth 2015; 29(5):702–7.
  22. Demir Y. Non-Pharmacological therapies in pain management. Pain management current issues and opinions. Available at: URL: http://cdn.intechopen.com/pdfs-wm/26152.pdf; 2012.
  23. Chen YW, Wang HH. The effectiveness of acupressure on relieving pain: a systematic review. Pain Manag Nurs 2014; 15(2):539-50.
  24. Chung UL, Hung LC, Kuo SC, Huang CL. Effect of LI4 and BL67 acupressure on labor pain and uterine contractions in the first stage of labor. J Nurs Res 2003; 11(4):251-60.
  25. Seyyedzadeh Aghdam N, Vakilian K, Masoomeh DA. Effect of BL32 and GB21 acupressure on labor pain in the first stage of labor. Complemen Med J Faculty Nurs Midwifery 2012; 2(1):104-10. (Persian).
  26. Ohlsen BA. Combination of acupuncture and spinal manipulative therapy: management of a 32-year-old patient with chronic tension-type headache and migraine. J Chiropr Med 2011; 11(3):192-201.
  27. Chaibi A, Tuchin PJ. Chiropractic spinal manipulative treatment of migraine headache of 40-year duration using Gonstead method: a case study. J Chiropr Med 2011; 10(3):189-93.
  28. Bassampour SH, Nikbakht Nasrabadi A, Mehran A, Poresmaeil Z, Valiee S. Effect of acupressure on patients' anxiety and vital sign before abdominal surgeries. Hayat 2013; 14(2):23-34.
  29. Yousefshahi F, Dahmardeh AR, Khajavi M, Najafi A, Khashayar P, Barkhordari K. Effect of dexamethasone on the frequency of postdural puncture headache after spinal anesthesia for cesarean section: a double-blind randomized clinical trial. Acta Neurol Belg 2012; 112(4):345-50.
  30. Hartrick CT, Kovan JP, Shapiro S. The numeric rating scale for clinical pain measurement: a ratio Measure? Pain Pract 2003; 3(4):310-6.
  31. Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. J Clin Nurs 2005; 14(7):798-804.
  32. Hjermstad MJ, Fayers PM, Haugen DF, Caraceni A, Hanks GW, Loge JH, et al. Studies comparing numerical rating scales, verbal rating scales, and visual analogue scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manage 2011; 41(6):1073-93.
  33. Kermanshahi S, Sadrizadeh R, Nafisi S. The effect of auto acupressure on reliefing headache in Migraine. J Kermanshah Univ Med Sci 2010; 13(4):290-8. (Persian).
  34. Stein A. Acupressure Guide: alleviate headaches, neck and joint pain, anxiety attacts and other ailments. Bloomington: AuthorHouse; 2005.
  35. Sepehri N. Treatment without drug. Tehran: Dastan publisher; 2013.
  36. Nofal WH, Mahmoud MS, Al Alim AA. Does preoperative gabapentin affects the characteristics of post-dural puncture headache in parturients undergoing cesarean section with spinal anesthesia? Saudi J Anaesth 2014; 8(3):359-63.
  37. Yang B, Li DL, Dong P, Zhang XY, Zhang L, Yu JG. Effect of dexamethasone on the incidence of post-dural puncture headache after spinal anesthesia: a randomized, double-blind, placebo-controlled trial and a meta-analysis. Acta Neurol Belg 2015; 115(1):59-67.
  38. Saghaleini SH, Ghorbanian EA. Comparison of the effect of gabapentin, pregabalin and acetaminophen in post-dural puncture headache. Iran J Obstet Gynecol Infertil 2014; 16(82):1-7. (Persian).
  39. Foruzeshfard M, Validad E, Mirmohamadkhani M, Moradan S. Type of anesthesia chosen by mothers for cesarean section in their first delivery and its related factors in selected hospitals in year 2012. Iran J Obstet Gynecol Infertil 2013; 15(39):1-8. (Persian).
  40. Ahmed UT, Alwahab RA, Ismail S, Alillah KA, Alysaa F. Impact of spinal anesthesia on cesarean section outcome in Omdurman maternity hospital-Sudan 2011. Sudan J Med Sci 2012; 7(3):147-52.
  41. Naik RP. A study of patients perception about knowledge of anesthesia & anesthesiologist. India J Anaesth 2002; 46(1):26-30.
  42. Zolfaghari M, Mohammadi A, Mojtahedzadeh R, Gharib M. Maternal newborn nursing. 9th ed. Tehran: Boshra Publication; 2014.
  43. de Almeida SM, Shumaker SD, LeBlanc SK, Delaney P, Marquie-Beck J, Ueland S, et al. Incidence of post-dural puncture headache in research volunteers. Headache 2011; 51(10):1503-10.
  44. Rasooli S, Moslemi F, Baybordi A. Post-dural puncture headache in the obstetric patient: needle size, number of dural puncture and timing of ambulation. Int J Womens Health Reprod Sci 2015; 3(3):163-7.
  45. Van deVelde M, Schepers R, Berends N, Vandermeersch E, De Buck F. Ten years of experience with accidental dural puncture and post-dural puncture headache in a tertiary obstetric an aesthesia department. Int J Obstet Anesth 2008; 17(4):329-35.
  46. Genc M, Sahin N, Maral J, Celik E, Kar AA, Usar P, et al. Caesarean section with spinal anesthesia and postspinal headache. Am J Obstet Gynecol Res 2015; 1(1):1-7.
  47. Ebrahimian A, Heydari M, Saberi Zafarghandi MB. Comparison of female sexual dysfunctions before and during pregnancy. Iran J Obstet Gynecol Infertil. 2010;13(5):30-6.
  48. Ebrahimian A, Heydari M, Saberi-Zafarghandi M. B, Delavari S. Comparing Sexual Dysfunctions in Men Before and During Their Wives' Pregnancy. Iran J Obstet Gynecol Infertil. 2012;15(33):19-25.
مجله زنان، مامایی و نازایی ایران
دوره 18، شماره 184
هفته دوم اسفند ماه 1394
اسفند 1394
صفحه 9-19

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