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Non-Pharmacologic Pain Control in Labor

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1. Sequential application of non-pharmacological interventions reduces the severity of labour pain, delays use of pharmacological analgesia, and improves some obstetric outcomes: a randomised trial Full Text available with Trip Pro

Sequential application of non-pharmacological interventions reduces the severity of labour pain, delays use of pharmacological analgesia, and improves some obstetric outcomes: a randomised trial Among women in labour, does sequential application of non-pharmacological interventions relieve labour pain, shorten labour, and delay pharmacological analgesia use?Randomised trial with concealed allocation, assessor blinding, and intention-to-treat analysis.Eighty women admitted in labour at the end (...) allowed delayed and reduced use of analgesic medication. Other significant benefits included: faster expulsion (MD 18minutes, 95% CI 5 to 30), improved neonatal status, and higher maternal satisfaction. No adverse effects were identified.This sequence of non-pharmacological interventions significantly reduced labour pain from 4cm to beyond 7cm of cervical dilation, as reflected in decreased and delayed use of analgesic medication. Women in labour could be encouraged to use these interventions

2018 EvidenceUpdates

2. Non-Pharmacologic Pain Control in Labor

Non-Pharmacologic Pain Control in Labor Non-Pharmacologic Pain Control in Labor Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Non (...) -Pharmacologic Pain Control in Labor Non-Pharmacologic Pain Control in Labor Aka: Non-Pharmacologic Pain Control in Labor , Labor Alternatives to Analagesics , Natural Childbirth Assistance From Related Chapters II. Management: Beneficial Measures ( ) Decreases obstetric interventions Warm water baths Mixed results on efficacy in studies Safe option for limited period (<1-2 hours) Wait until active labor (cervical dilation >5 cm) Keep water less than III. Management: Unclear efficacy (small or inconclusive

2018 FP Notebook

3. Experiences of midwives on pharmacological and non-pharmacological labour pain management in Ghana Full Text available with Trip Pro

Experiences of midwives on pharmacological and non-pharmacological labour pain management in Ghana Due to the debilitating effects of severe labour pains, labour pain management continues to be an important subject that requires much attention. Thus, this study sought to gain a detailed insight into the experiences of midwives on pharmacological and non-pharmacological labour pain management strategies in a resource limited clinical context.A descriptive exploratory qualitative design (...) was adopted for this study which allowed in-depth follow-up of the midwives' comments resulting in a full understanding of emerging findings. Face-to-face individual interviews were conducted, transcribed and data were analysed using content analysis procedures. Verbatim quotes were used to support the findings.Midwives employed different pain control measures including pharmacological and non-pharmacological methods such as psychological care, sacral massage and deep breathing exercises. Doctors

2017 Reproductive health

4. Effectiveness of breathing exercises during the second stage of labor on labor pain and duration: a randomized controlled trial. (Abstract)

Effectiveness of breathing exercises during the second stage of labor on labor pain and duration: a randomized controlled trial. Some research exists on the effect of non-pharmacological approaches for labor pain relief. However, there is limited information about effectiveness of breathing exercises in pregnant women to reduce maternal pain during labor.To determine whether breathing exercises for pregnant women during the second stage of labor have beneficial effects on maternal pain (...) , duration of labor, and the first-minute Appearance, Pulse, Grimace, Activity and Respiration (APGAR) scores.This randomized clinical trial involved 250 pregnant women, who were randomly divided into two groups: intervention group (IG; n = 125) and control group (CG; n = 125). IG received one session breathing exercise training and performed breathing exercises during the second stage of labor versus the CG that did not receive any breathing exercise training.The effects of breathing exercises

2018 Journal of integrative medicine Controlled trial quality: uncertain

5. Evaluation of different doses of transcutaneous nerve stimulation for pain relief during labour: a randomized controlled trial Full Text available with Trip Pro

Evaluation of different doses of transcutaneous nerve stimulation for pain relief during labour: a randomized controlled trial Pain during labour is one of the most intense pain that women may experience in their lifetime. There are several non-pharmacological analgesic methods to relieve pain during labour, among them transcutaneous electrical nerve stimulation (TENS). TENS is a low-frequency electrotherapy technique, analgesic type, generally used in musculoskeletal pathology, but it has also (...) come to be used as an alternative treatment during labour. The purpose of this study is to investigate the pain-relieving effect of a TENS application during labour and to find out the most effective dose.This study is a randomized, double-blind, placebo-controlled trial. TENS therapy was initiated at the beginning of the active phase of labour. Participants were randomly assigned to three groups (21 per group: two active TENS and one placebo). Active TENS 1 intervention consisted in a constant

2018 Trials Controlled trial quality: predicted high

6. Nitrous Oxide Use for Labor Pain Management

outcomes among infants of women using N2O and who used other methods of labor pain management, including epidurals, opioids, TENS, and non-pharmacologic methods. This study reported no significant differences between groups in neonatal adaptive capacity scores (NACS). Critical Outcome: Mode of birth Six studies in the AHRQ review compared the mode of birth among women who used N2O to women who used other methods of pain relief and determined that there was insufficient evidence, primarily due to poor (...) included in this review. A MEDLINE® (Ovid) search based on the search strategy of the AHRQ SR did not locate any additional eligible studies. 7 Nitrous Oxide Use for Labor Pain Management Approved January 14, 2016 EVIDENCE SUMMARY The AHRQ SR (Likis, 2012) included a total of 59 studies reported in 58 publications (13 RCTs, 7 crossover RCTs, 4 non-randomized clinical trials, 14 prospective cohorts, 1 retrospective cohorts, 3 case series, 4 case-control studies, 11 cross sectional studies, and 2 trend

2016 Oregon Health Evidence Review Commission

7. Pain management for women in labour: an overview of systematic reviews. Full Text available with Trip Pro

Pain management for women in labour: an overview of systematic reviews. The pain that women experience during labour is affected by multiple physiological and psychosocial factors and its intensity can vary greatly.  Most women in labour require pain relief. Pain management strategies include non-pharmacological interventions (that aim to help women cope with pain in labour) and pharmacological interventions (that aim to relieve the pain of labour).To summarise the evidence from Cochrane (...) systematic reviews on the efficacy and safety of non-pharmacological and pharmacological interventions to manage pain in labour. We considered findings from non-Cochrane systematic reviews if there was no relevant Cochrane review.We searched the Cochrane Database of Systematic Reviews (The Cochrane Library 2011, Issue 5), The Cochrane Database of Abstracts of Reviews of Effects (The Cochrane Library 2011, Issue 2 of 4), MEDLINE (1966 to 31 May 2011) and EMBASE (1974 to 31 May 2011) to identify all

2012 Cochrane

8. The effect of music on pain and anxiety of women during labour on first time pregnancy: A study from Turkey. (Abstract)

indicated that their pain was statistically less in the experimental group. Trait anxiety scores of the women in labor were similar for experimental and control groups. Following the practice, state anxiety average scores became lower in favor of the experimental group and the correlation was statistically significant.In order to facilitate women's coping with labor pain and improve their wellbeing with the activity during the labor, musicotherapy, a non-pharmacological method, is an effective, simple (...) The effect of music on pain and anxiety of women during labour on first time pregnancy: A study from Turkey. This study aims at analyzing the effect of music on pain and anxiety felt by women in labor during their first pregnancy.When the pregnant women in the experimental group progressed into the active phase of the labor, they were made to listen to music in Acemasiran mode with earplugs for 3 h (20 min of listening with 10-min breaks).It was observed that after the first-hour women

2018 Complementary Therapies in Clinical Practice

9. Approaches to Limit Intervention During Labor and Birth

, pharmacologic methods mitigate pain, but they may not relieve anxiety or suffering. Data about the relative effectiveness of non- pharmacologic techniques are limited because, until recently, evaluation of labor pain has relied on the use of the numeric pain scale of 1–10, which some have argued is insufficient to assess the complex and multi- factorialexperienceoflabor(32).Asanalternative,acop- ing scale has been developed and approved by the Joint Commission. The coping scale asks, “On a scale of 1 to 10 (...) /14651858.CD000111.pub4. 35. Derry S, Straube S, Moore RA, Hancock H, Collins SL. Intracutaneous or subcutaneous sterile water injection compared with blinded controls for pain management in labour. Cochrane Database of Systematic Reviews 2012, VOL. 133, NO. 2, FEBRUARY 2019 Committee Opinion Limit Intervention During Labor and Birth e171Issue 1. Art. No.: CD009107. DOI: 10.1002/14651858. CD009107.pub2. 36. Jones L, Othman M, Dowswell T, Alfirevic Z, Gates S, Newburn M, et al. Pain management for women

2019 American College of Obstetricians and Gynecologists

10. Non-Pharmacologic Pain Control in Labor

Non-Pharmacologic Pain Control in Labor Non-Pharmacologic Pain Control in Labor Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Non (...) -Pharmacologic Pain Control in Labor Non-Pharmacologic Pain Control in Labor Aka: Non-Pharmacologic Pain Control in Labor , Labor Alternatives to Analagesics , Natural Childbirth Assistance From Related Chapters II. Management: Beneficial Measures ( ) Decreases obstetric interventions Warm water baths Mixed results on efficacy in studies Safe option for limited period (<1-2 hours) Wait until active labor (cervical dilation >5 cm) Keep water less than III. Management: Unclear efficacy (small or inconclusive

2015 FP Notebook

11. Birth ball for pregnant women in labour research protocol: a multi-centre randomised controlled trial. Full Text available with Trip Pro

Birth ball for pregnant women in labour research protocol: a multi-centre randomised controlled trial. Birth ball is one of the non-pharmacologic pain relief methods to help mothers cope with the labouring process. A randomised controlled trial (RCT) is conducted to evaluate the effectiveness, safety and harm of birth ball use by pregnant women in labour compared to treatment as usual group.A prospective multi-centre randomised controlled trial (RCT) will be conducted in Obstetrics (...) midwifery care. The target sample size is 512. The primary outcome measures are maternal pain intensity, satisfaction with pain relief, sense of control in labour, assisted delivery and satisfaction with childbirth experience. Labour pain relief is measured by visual analogue scale (VAS). Other outcomes will be measured through four different validated questionnaires. To control for potential cluster effects, a linear mixed model will be used. An intention-to-treat analysis is adopted and performed

2019 BMC Pregnancy and Childbirth Controlled trial quality: predicted high

12. The Effect of LI4 Acupressure on Labor Pain Intensity and Duration of Labor: A Randomized Controlled Trial. Full Text available with Trip Pro

group, and a control group in which no pharmacological or non-pharmacological methods of pain relief were used. Pain intensity was measured by visual analog scale before and after the intervention in the first stage of labor. Pressure or touch was applied for 30 minutes during uterine contractions.The difference in the pain scores between the acupressure and control group was statistically significant (p<0.001) but there was no statistically significant (p=0.942) difference in the duration (...) The Effect of LI4 Acupressure on Labor Pain Intensity and Duration of Labor: A Randomized Controlled Trial. To evaluate the effect of LI4 acupressure on labor pain and duration during the first stage of labor.Parturient women (n=149) with singleton pregnancies in the active phase of spontaneous labor, without any medical or obstetric problems, were enrolled in this single-blinded, randomized, clinical trial. Participants were placed into one of three groups: an LI4 acupressure group, a touching

2015 Oman medical journal Controlled trial quality: uncertain

13. Managing Chronic Non-Terminal Pain in Adults Including Prescribing Controlled Substances

analgesia is not possible for many patients. • Expectations. Patient and provider expectations should be articulated clearly at the beginning of treatment and reviewed regularly. A written controlled substance treatment agreement is appropriate for most patients treated with ongoing daily opioid therapy. [1D]* • Non-pharmacologic therapies. Begin with these therapies (e.g., exercise, heat, sleep hygiene). • Medical treatment. Choose drugs based on presumed pain type and the patient’s comorbidities (...) in an independent home exercise program. An ergonomic work site evaluation and consultation with an occupational medicine specialist should be considered in patients who are disabled from work. Patients with continued pain and disability should be referred to a musculoskeletal specialist (e.g., orthopedic surgeon, rheumatologist, physiatrist, sports medicine specialist). Osteoarthritis. Optimal medical management of osteoarthritis consists of non-pharmacologic measures and pharmacologic treatment. Non

2017 University of Michigan Health System

14. Effect of direct current pulse stimulating acupoints of JiaJi (T10-13) and Ciliao (BL 32) with Han's Acupoint Nerve Stimulator on labour pain in women: a randomized controlled clinical study. (Abstract)

Effect of direct current pulse stimulating acupoints of JiaJi (T10-13) and Ciliao (BL 32) with Han's Acupoint Nerve Stimulator on labour pain in women: a randomized controlled clinical study. To assess the clinical effect and safety of direct current (DC) pulse produced by Han's Acupoint Nerve Stimulator in reduction (HANS) of labor pain.Totally 120 participants were enrolled in this clinical trial, and were randomly divided into 4 groups including: HANS group, patient controlled intravenous (...) of PCIA group that used oxytocin was lower than that of other three groups. There was no significant difference in postpartum hemorrhage between four groups. The side effects of the PCEA group were itching, uroschesis and neonatal asphyxia and PCIA group were nausea and vomiting and neonatal asphyxia. However, fewer side-effects were observed in the HANS group.The DC pulse produced by HANS may be a non-pharmacological alternative to labor pain with fewer side effects.

2016 Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan / sponsored by All-China Association of Traditional Chinese Medicine, Academy of Traditional Chinese Medicine Controlled trial quality: uncertain

15. Birth ball or heat therapy? A randomized controlled trial to compare the effectiveness of birth ball usage with sacrum-perineal heat therapy in labor pain management. (Abstract)

Birth ball or heat therapy? A randomized controlled trial to compare the effectiveness of birth ball usage with sacrum-perineal heat therapy in labor pain management. Labor pain and its management is a major concern for childbearing women, their families and health care providers. This study aimed to investigate the effects of two non-pharmacological methods such as birth ball and heat therapy on labor pain relief.This randomized control trial was undertaken on 90 primiparous women aged 18-35 (...) years old who were randomly assigned to two intervention (birth ball and heat) and control groups. The pain score was recorded by using Visual Analogue Scale (VAS) before the intervention and every 30 min in three groups until cervical dilatation reached 8 cm.The mean pain severity score in the heat therapy group was less than that of in control group at 60 and 90 min after intervention (p < 0.05). In addition there were significantly differences between the pain scores in the birth ball group after

2016 Complementary Therapies in Clinical Practice Controlled trial quality: uncertain

16. Management of Spontaneous Labour at Term in Healthy Women

dystocia to increase the likelihood of a vaginal birth and optimize birth outcomes. Evidence Published literature was retrieved through searches of PubMed and the Cochrane Library in October 2011 using appropriate, controlled vocabulary (e.g., labour pain; labour, obstetric; dystocia) and key words (e.g., obstetric labor, perineal care, dysfunctional labor). When appropriate, results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies (...) options in labour. These may include pharmacological and non-pharmacological measures. (III-A) 9. Each woman should be provided with evidence-based information about labour analgesia options prior to the onset of labour and offered ample opportunity to discuss the risks and benefits of each option available at her planned site of delivery. (III-A) 10. The use of meperidine as labour analgesia should be avoided due to its long-acting active metabolites and negative effects on neonatal behaviours. (II

2016 Society of Obstetricians and Gynaecologists of Canada

17. Effect of dance labor on the management of active phase labor pain & clients' satisfaction: a randomized controlled trial study. Full Text available with Trip Pro

Effect of dance labor on the management of active phase labor pain & clients' satisfaction: a randomized controlled trial study. There are a wide variety of non- pharmacologic pain relief techniques for labor which include pelvic movement, upright position, back massage and partner support during the first stage of labor. The effectiveness of dance labor- which is a combination of these techniques- has not been evaluated.This study aimed to evaluate the effectiveness of dance labor in pain (...) reduction and woman's satisfaction during the first stage of labor.60 primiparous women aged 18-35 years old were randomly assigned to dance labor and control groups. In the dance labor group, women were instructed to do standing upright with pelvic tilt and rock their hips back and forth or around in a circle while their partner massaged their back and sacrum for a minimum of 30 minutes. In the control group, the participants received usual care during physiologic labor. Pain and satisfaction scores

2014 Global journal of health science Controlled trial quality: uncertain

18. Core Competencies for Management of Labour

of labour.Core Nursing Practice Competencies: Managing Labour 4 Perinatal Services BC Copyright © 2011 - PSBC Managing Labour in an Institutional Setting if the Primary Maternal Care Provider is Absent KNOWLEDGE of: SKILL in: JUDGMENT or reasoning in: ATTITUDE by: 2. Organization, Coordination and Provision of Care • Methods used to promote labour progress and comfort • Physical and psychological needs during labour and birth • Non-pharmacologic comfort techniques and pharmacologic pain relief options (...) • Monitoring woman’s response to pain relief options • Administering appropriate medications/ treatment • Collecting specimens, and interpreting laboratory data • Initiating intravenous access • Facilitating breastfeeding initiation and maternal- newborn interaction • Performing neonatal resuscitation • Advocating for spontaneous labour • Ensuring freedom of movement as a means of promoting normal labour • Recognizing indications for and the effects of non-pharmacological or pharmacological pain relief

2014 British Columbia Perinatal Health Program

19. Comparative Effectiveness of Analgesics To Reduce Acute Pain in the Prehospital Setting

for hypotension, respiratory depression, and mental status changes. Results. We included 52 randomized controlled trials and 13 observational studies. Due to the absence or insufficiency of prehospital evidence we based conclusions for initial analgesia on indirect evidence from the emergency department setting. As initial analgesics, we found no evidence of a clinically important difference in the change of pain scores with opioids versus ketamine administered primarily intravenously (IV) (low SOE), IV (...) 31 Ketamine Versus Nonsteroidal Anti-Inflammatory Drugs 31 Morphine Versus Fentanyl 32 KQ 2. What are the comparative harms of analgesic agents when administered by EMS personnel to control moderate-to-severe pain in the prehospital setting? 33 KQ 2a. How do harms vary by patient characteristics? 33 KQ 2b. How do harms vary by routes of administration, dosing, and timing? 33 KQ 2c. What are the comparative harms to EMS personnel who administer analgesics to patients for the control of moderate

2019 Effective Health Care Program (AHRQ)

20. Complementary and alternative therapies to relieve labor pain: A comparative study between music therapy and Hoku point ice massage. (Abstract)

Complementary and alternative therapies to relieve labor pain: A comparative study between music therapy and Hoku point ice massage. Pain is a common experience for women during labor. In the present study, we compared the effect of two types of non-pharmacological pain relief methods "music therapy" and "Hoku point ice massage" on the severity of labor pain.This prospective, randomized, controlled trial was conducted in Shahrekord, Iran, from September 2013 to June 2014. We randomly assigned (...) 90 primiparous women who expected a normal childbirth into three groups: group "A" received music therapy, group "B" received Hoku point ice massage, and group "C" received usual labor care. At the beginning of the active phase (4 cm cervical dilation) and before and after each intervention (at dilations 4, 6, and 8 cm), the intensities of labor pain were measured using Visual Analogue Scale (VAS).At the beginning of the active phase, the mean VAS scores were 5.58 ± 1.29, 5.42 ± 1.31, and 6.13

2015 Complementary Therapies in Clinical Practice Controlled trial quality: uncertain

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