Acupuncture or acupressure for pain management in labour

Evidence Summaries

Level of Evidence = D
Acupuncture might possibly have some effect for reducing pain and use of pharmacological management compared to usual care, however the evidence in limited.

A Cochrane review 1 included 13 studies with a total of 1986 subjects. 9 trials reported on acupuncture and 4 trials reported on acupressure. There was no significant difference in pain intensity with acupuncture compared with placebo (SMD 0.04; 95% CI -0.22 to 0.30; 2 trials, n=240) or standard care (SMD -0.14, 95% CI -0.55 to 0.28; 1 trial, n=90), but less pain was found in 1 trial comparing acupuncture with no intervention. Satisfaction with pain relief was increased in one trial, but not in the other one. Reduced use of pharmacological analgesia was found in one trial of acupuncture compared with placebo (RR 0.72, 95% CI 0.58 to 0.88, 136 women), and compared with standard care, however, there was significant heterogeneity (RR 0.68, 95% CI 0.56 to 0.83, 3 trials, 704 women). Pain intensity was reduced in the acupressure group compared with a placebo control (SMD -0.55, 95% CI -0.92 to -0.19, one trial, 120 women), and a combined control (SMD -0.42, 95% CI -0.65 to -0.18, 2 trials, 322 women).

References

1. Smith CA, Collins CT, Crowther CA et al. Acupuncture or acupressure for pain management in labour. Cochrane Database Syst Rev 2011;(7):CD009232.  [PMID:21735441]


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