Non-pharmacological Pain Relief Intervention in Labour

Non-pharmacological unhinge Relief Intervention in LabourCHAPTER IIREVIEW OF LITERATUREReview of belles-lettres is an important step in the development of any research project. This chapter deals with the information collected with relevant to the present(a) hold by means of the published and unpublished materials. These publications were the foundation to carry unwrap the research work. This helps the investigator to analyze what is already known almost the guinea pig and to describe the modes of inquiry.Research literatures ar look buttocksed under the fol small(a)ing headingsA lit related to non-pharmacological fuss quietus intervention.B writings related to bum abrase as a complementary therapy for infliction management in exertion.A Literature related to non-pharmacological torture stand-in intervention.Davim, Torres Dantas (2009) conducted a field of operations to evaluate the force outiveness of non- pharmacological strategies to mollify hassle in par turient in labour. This is before and afterward therapeutic intervention clinical streak, performed with coke parturients applying breathing exercise, muscle relaxation, lumbosacral rub down and shower. A visual par every(prenominal)el of latitude scale was used for data collection. Oxytocin was administered in 81% of cases, merely 15% did non baffle any medication. A world-shattering contrast was observed in imposition relief after using non- pharmacological strategies, showing reduced smart as cervical dilatation increased. cent April (2004) The control of labour hassle and prevention of suffering are mull concerns of clinicians and their clients. Nonpharmacologic entreees toward these goals are consistent with midwifery management and the cho scratchs of many women. They undertook a literature search of scientific articles cataloged in CINAHL, PUBMED, the Cochrane Library, and AMED databases relating to the potential of 13 non-pharmacologic methods used to relie ve injure and reduce suffering in labour.AcupunctureAcupuncture, an important and quaint component of traditional Chinese medicine, is gradually being integrated with effected medicine in the West. Acupuncture is believed to initiate, control, or accelerate physiologic functions, and thus, temper organ malfunctions, heal illnesses, or relieve discomforting symptoms through interjection of pretty needles into the pare down at a combination of specific crowns along meridians (channels of energy, called Qi, enounce chee) in the body, followed by rotation, heating, or electrical stimulation(electro-stylostixis) of the needles.Smith, Collins, Cyna, Crowther (2006)A systematic review of acupuncture for hurting relief in labor reported that acupuncture was associated with a trend toward slight(prenominal) use of pharmacological analgesia (RR 0.70, 95% CI 0.49-1.00) .Compared to controls who had no or sham acupuncture, women who underwent acupuncture were more(prenominal) relax ed and used less pharmacological hurt relief, but did not have pass up pain intensity aim markers. Maternal satisfaction was high among all the women in twain the acupuncture and control companys.Acu pressure levelAcupressure, or Shiatsu, a simpler choice to acupuncture, is pressure with fingers or small beads at acupuncture points.Chung, Hung, Kuo Huang (2003). A study to determine L14 and BL67 acupressure on labour pain during basic typify of labour .A total of 127 parturient were randomly assigned to three pigeonholings. distributively assemblage received only one of the following treatments L14 and BL67 acupressure, light skin stroking or no treatment. There was a significant diversity in labour pain in the source concourse compared with the cardinal others.AromatherapyAromatherapy is the science of using highly concentrated essential oils or essences distilled from plants in order to utilize their therapeutic properties . Abbaspoor and Mohammadkhani (2013) The aim of this study was to investigate the effect of aromatherapy work with Lavender oil. This was a prospective, randomise, controlled trial that was conducted in 2008 Tehran, Iran. The subjects included N=60 primiparous women in 3842 week gestational age, who were expected to have a normal delivery. They were randomly assigned to twain concourses. The first group received only work (n=30) and the second group received aromatherapy massage with Lavender oil (n=30). The intensity of pain was mensurable with the visual parallel of latitude scale ( vessel). Results showed that pain intensity before and after intervention were significantly reduce in the lavender aromatherapy massage group in the latent and active phase, and they had a lower duration of first and second distributor point of labour. Reeja Mariam Joseph Philomena Fernandes(2013) The study was conducted to prise the effectiveness of jasmine oil massage on labour pain during first symbolise of labour among 40 pr imigravida women. The study design adopted was true data-based approach with pre-test berth-test control group design. The demographic Proforma were collected from the women by interview and optic analog scale was used to measure the level of labour pain in both(prenominal) the groups. data obtained in these areas were analysed by descriptive and illative statistics. A significant difference of opinion was found in the data-based group( t 9.869 , p0.05) and the post-test (t 11.75, pBreathing exercises Kamalifard et al.,(2000) A quasi-experimental study was conducted for 42 mothers selected randomly carve up into both groups of massage 2 and breathing 2. The breathing groups employed the techniques during the first or second stage of labour at 4, 6, 8 and 10 centimeter of dilatation for 30 minutes. The intensity of pain was measured by a numerical rating scale (NRS) 30 minutes after determining dilatation. The ERA performed massaging at the same dilatations for M1 and M2 g roups. Massage at 4 and 6 cm dilatations and breathing at most dilatations decreased pain hemorrhoid significantly. The choosing of one or both methods for labour pain relief and decreasing caesarean section rate is suggested.HydrotherapyHydrotherapy is an effective, alternative intervention that can be used by business concern providers as a nonpharmacological pain relief method to help labouring women fuck with labour. A wide variety of pain relief measures are ready(prenominal) to women in labour.Entisar Manal (2012) This study assessed obliges knowledge about the use of hydropathy as a Nonpharmacologic pain-relief techniques during labour and identify the barriers of hydrotherapy to be used in Womens Health Center, Egypt. A descriptive study design was utilized in this study. The 120 nurses who works in obstetrics department. They showed that approximately three reap (73.3%) of the participant nurses knowl-edge were adequate, while (26.7) of nurses had inadequate knowledge about the use of hydrotherapy in labour. Nurses encounter that hospital policy (100%) followed by environ-mental factors (52%) are the major barriers to the use of hydrotherapy in labour. Effort required for hydrotherapy (48%) and military man resources (41%) are indicated to be equivalent barrier of the use of hydrotherapy in labour. Their knowledge represented (26.7%) and not considered to be a major lend barrier to the use of hydrotherapy during labour.HypnosisCyna, McAuliffe Andrew (2004) They examined the evidence regarding the personal effects of hypnosis for pain relief during childbirth. Five RCTs and 14 non-randomized comparisons (NRCs) studying 8395 women were identified where hypnosis was used for labour analgesia. quad RCTs including 224patients examined the primary outcomes of interest. One RCT rated poor on quality assessment. Meta-analyses of the three be RCTs showed that, compared with controls, fewer parturients having hypnosis required analgesia, relative ris k=0.51 (95% confidence interval 0.28, 0.95). Of the two included NRCs, one showed that women using hypnosis rated their labour pain less knockout than controls (PMusic therapy Phumdoung Good (2003) A randomized controlled trial of 110 primiparous women in active phase of labour were assigned to soft unison group for 3hrs (n=55) or a control group (n=55). Dual VAS were used to measure pain before starting the study and all(prenominal) 3 hrs. The results indicate that music group women had significantly less pain sensation(pPositionDeClercq et al., (2006) A national fall over of childbearing experiences in the linked States in 2005 reported that after admission to the hospital, most women (76 per centum) did not laissez passer around. This percentage was slightly high than in a similar survey conducted three years earlier. At that time, the most common reason the women gave for not walking was that they were connected to things (67percent), unable to support self due to pai n medication (32 percent), and told not to walk around (28 percent). However, 58 to 60 percent of the women did report changing positions to relieve pain during labour.Yoga Chuntharapat et al.,(2008) A randomized trial was conducted using 74-primigravid Thai women who were equally divided into two groups (experimental and control). The yoga program tough six, 1-h school terms at prescribed weeks of gestation. The experimental group was found to have higher levels of maternal comfort during labour and 2 h post-labour, and experienced less subject evaluated labour pain than the control group. In each group, pain increased and maternal comfort decreased as labour progressed. The experimental group was found to have a shorter duration of the first stage of labour, as well as the total time of labour.B Literature related to bottom massage as a complementary therapy for pain management in labour. Patricia, Farah Paula (2012) A study conducted to evaluate the effectiveness of massage t herapy in managing labour pain among women in active labour. A randomized controlled trial in Vancouver of 77 healthy nulliparous women presenting in spontaneous labour, upto 5 hours the massage therapy was given. The mean cervical dilataion at the time of epidural insertion was 5.9cm(95% CI 5.2-6.7) compared to 4.9 in the control group. (95% CI 4.2-5.8) scores on the McGrill pain scale were consistently lower in the massage therapy group (13.3 vs 15.8 at 5-6cm 19.4 vs 28.3 at 7.8cm) although these differences were not satisfically significant. Vijayalakshmi S (2011) An experimental was conducted to assess the effectiveness of effleurage over lumbosacral region for reduction of pain perception during first stage of labour among primigravida mothers. The study samples were 60 primigravida mothers (30 in experimental group 30 in control group). The samples were selected using lottery method comes under probability simple random sampling technique. A have numerical categorical scale w as used to assess the level of pain perception among primigravida mothers during first stage of labour. The findings revealed that marked decrease in mean value from 3.43 in pre assessment level to 2.30 in post assessment level and the improvement mean was 2.86 and SD was 0.27 in experimental group.Umarani (2010) conducted a quasi experimental pretest posttest control group design to assess the effectiveness of back massage during the first stage of labour among primigravida mothers. 30 primigravida mothers were taken and assigned for experimental and control group equally. Pain perception was measured by using 0-10 numerical pain intensity scale. 20 minutes back massage was given to the experimental group after the 3cm cervical dilatation, when contractions started. Control group was allowed to follow the conventional method. The results showed that at that place was a significant reduction on pain perception of 2.2 than 3.6 in control group. Dsouza (2010) conducted a study on eff ectiveness of ice massage (acupressure L14) for the reduction of labour pain among intranatal women. A quasi experimental pretest-posttest only design was carried out on 49 intranatal women the pretest was 100mm visual analogue scales (VAS) and McGrill pain Questionaire. In the experimental group the mean posttest pain score (2.1) which is significantly lower than the mean pretest score (5.0) with a mean difference of (2.9).The calculated value(11.588) was more than the table value (2.093,pZahrani (2008). This study has been conducted to determine the effects of massage on intensity of pain during the first stage of labour in primiparous women who have attended Isfahan Shahid Beheshti hospital in 2005. In this randomize clinical trial, a total of 75 primiparous women in 38-42 week of low risk pregnancy were randomly divided in 3 groups. First group received 20 minutes of back effleurage massage at the periods of 4-5 cm, 6-7 cm, 8-10 cm, cervical dilation. An emotional support was of fered for second group in the same duration of time and the same cervical dilation. third group just received routine care during labour. In all groups, pregnant women were asked to evaluate their severity of pain before and after intervention. Data being obtained through the visual analogue scale, check list and reassessment form. Results Study result demonstrated that intensity of pain was significantly lower in massage group (pRefined olive oil is obtained from perfect(a) olive oils by refining methods, which do not lead to alterations in the initial glyceridic structure. It has a free acidity, expressed as oleic acid, of not more than 0.3 grams per 100 grams (0.3%) and its other characteristics correspond to those fixed for this category in this standard.The healthful use of olive oil is a non-selective inhibitor of cyclo-oxygenase similar to classical NSAIDs give care ibuprofen. Fifty grams of extra virgin olive oil is equivalent to about the tenth of a dose of ibuprofen. He alth benefits of olive oil are analgesia, Oil massage, bone growth, decreased aging, and decreased cardiovascular problems.Jeyalakshmi, Latha Venkatesan, Jamuna (2008) conducted a study on effectiveness of olive oil massage therapy upon low back pain of parturient mothers in the first stage of labour at Andhra mahila sabha,Chennai. 60 mothers were randomly selected for experimental and control group. Before and after massage therapy low back pain and feto maternal parameter was assessed in both groups. In experimental group 100% of them experienced moderate level of pain after massage therapy. The mean and standard deviation of low back pain score of the control group were high in comparison with olive oil therapy group (p=0.001). Kuhn (2004) conducted a study to assess the effectiveness of massage therapy on downcast pregnant women. 84 depressed pregnant women were recruited during the second trimester of pregnancy and randomly assigned to a massage therapy group and control group that received standard prenatal care alone. These groups were compared to each other. The massage therapy was for 20 minutes for 2 sessions by their significant other each week for 16 weeks of pregnancy. Immediately after the massage therapy sessions on the first and last days the woman reported lower levels of anxiety and depressed mood and less leg and back pain and also the massage group had higher dopamine and serotonin levels and lower levels of cortisol and norepinephrine.Chang, Wang, Chen,(2002) The third trial randomly assigned 60 women to receive massage or usual care. Massage was performed three times, once during each phase of the first stage of labour (latent, active and transition) and lasted for 30 minutes in each phase. Pain intensity was rated by a nurse observing each womans manifestations of pain using a present behavioural intensity (PBI) scale. Anxiety was measured using a visual analogue scale for anxiety (VASA). Although pain intensity increased steadily throu gh progressing phases of labor, the massage group had significantly lower pain intensity scores at each phase of labor (0.73 versus 1.30 in latent, 1.73 versus 2.17 in active, and 2.17 versus 2.87 in transition phases). Anxiety levels were significantly lower in the massage group only during the latent phase (37.2 versus 53.5 on a 100 point scale). Eighty-seven percent of the women in the massage group reported that the massage was helpful in providing pain relief and psychological support.Field et al., (1999) A study which involved 26 pregnant women were assigned to massage or relaxation therapy group for five weeks. The therapies consisted of 20 minute session in two ways a weeks. MANOVAs and ANOVAs were conducted for repeated measures. A significant group by pre-post session MANOVA, F(4,21) = 2.86p