Labrecque M, Nouwen A, Bergeron M, Rancourt J F
Department of Family Medicine, Laval University, Sainte-Foy, Quebec, Canada.
J Fam Pract. 1999 Apr;48(4):259-63.
Low back pain is common during labor. Our randomized controlled trial compared the effectiveness of 3 nonpharmacologic approaches for relief of back pain.
A total of 34 women suffering from low back pain during labor were randomly assigned to receive 1 of 3 treatments: (1) intracutaneous sterile water injections (ISW); (2) transcutaneous electrical nerve stimulation (TENS); and (3) standard care, including back massage, whirlpool bath, and liberal mobilization. Women self-evaluated both intensity and affective dimensions of pain using visual analog scales. Their evaluations of control and satisfaction were assessed using adapted versions of the Labour Agentry Scale and the Labor and Delivery Satisfaction Index.
Women in the ISW group rated the intensity and unpleasantness of pain during the experimental period significantly lower than women in the standard care group or the TENS group, (P = .001 and P = .003, respectively). Similar results were observed for intensity (P = .01) and unpleasantness (P = .03) of pain assessed just before delivery or request for an epidural. Mean pain intensity at 15 and 60 minutes after randomization was significantly reduced in the ISW group compared with the 2 other groups. There was no significant difference in the 3 groups in the level of control and satisfaction with labor and delivery, but less women in the ISW group indicated that they would like to receive the same treatment for back pain during another delivery.
Intracutaneous sterile water injections are more effective than standard care (back massage, bath, and mobilization) or transcutaneous electrical nerve stimulation for relieving low back pain during labor.
分娩期间下背痛很常见。我们的随机对照试验比较了三种非药物方法缓解背痛的效果。
共有34名分娩期间患有下背痛的女性被随机分配接受三种治疗中的一种：（1）皮内注射无菌水（ISW）；（2）经皮电刺激神经疗法（TENS）；（3）标准护理，包括背部按摩、漩涡浴和适度活动。女性使用视觉模拟量表对疼痛的强度和情感维度进行自我评估。使用改良版的分娩代理量表和分娩满意度指数评估她们对控制和满意度的评价。
ISW组女性在实验期间对疼痛强度和不愉快程度的评分显著低于标准护理组或TENS组女性（分别为P = 0.001和P = 0.003）。在分娩前或要求硬膜外麻醉时评估的疼痛强度（P = 0.01）和不愉快程度（P = 0.03）也观察到类似结果。与其他两组相比，ISW组在随机分组后15分钟和60分钟时的平均疼痛强度显著降低。三组在分娩控制和满意度水平上没有显著差异，但ISW组中表示希望在下次分娩时接受相同背痛治疗的女性较少。
皮内注射无菌水在缓解分娩期间的下背痛方面比标准护理（背部按摩、沐浴和活动）或经皮电刺激神经疗法更有效。
