Ganji Zhila, Shirvani Marjan A, Rezaei-Abhari Farideh, Danesh Mahmonir
Department of Midwifery, Mazandran University of Medical Science, Sari, Iran.
Iran J Nurs Midwifery Res. 2013 Jul;18(4):298-303.
BACKGROUND: Labor pain is one of the severest pains that cause many women request cesarean section for fear of pain. Thus, controlling labor pain is a major concern of maternity care. Nowadays, interest in non-pharmacological pain relief methods has been increased because of their lower side effects. The effects of discrete heat and cold on decreasing labor pain have been reported but there was no evaluation of the effects of simultaneous heat and cold. The aim of this study was to investigate the effect of intermittent heat and cold on pain severity and childbirth outcomes. MATERIALS AND METHODS: This study was a randomized controlled trial. Sixty-four nulliparous women with term, One fetus, and low-risk pregnancy were divided into the intervention (32 participants) and the control group (32 participants) by random allocation. Excluding criteria were: administration of pain relief drugs, skin disease in the field of intervention, fetal distress, bleeding, fever, and disagreement with participation in the study. Warm and cold packs were used intermittently on low back and lower abdomen during the first phase and on perineum during the second phase of labor. Pain intensity was assessed with Visual Analogue Scale. Descriptive statistic, chi square, and t-test were used for data analysis. RESULTS: There were no significant differences in demographic and midwifery characteristics and the baseline pain between two groups. The pain was significantly lower in intervention group during the first and second phases of labor. Duration of the first and third phases of labor was shorter in the case group. There were no significant differences in type of delivery, perineal laceration, oxytocin uptake, fetal heart rate, and APGAR between two groups. DISCUSSION: Local warming with intermittent cold pack can reduce labor pain without adverse effects on maternal and fetal outcomes. It is an inexpensive and simple method. CONCLUSION: Intermittent local heat and cold therapy is a no pharmalogical, safe and effective method to relief labor pain.
背景：分娩疼痛是最剧烈的疼痛之一，许多女性因惧怕疼痛而要求剖宫产。因此，控制分娩疼痛是产科护理的主要关注点。如今，由于非药物性疼痛缓解方法副作用较小，人们对其的兴趣有所增加。已有报道离散的热疗和冷疗对减轻分娩疼痛有效果，但尚未评估同时进行热疗和冷疗的效果。本研究的目的是探讨间歇性热疗和冷疗对疼痛严重程度及分娩结局的影响。 材料与方法：本研究为随机对照试验。64名足月、单胎、低风险妊娠的初产妇通过随机分配分为干预组（32名参与者）和对照组（32名参与者）。排除标准为：使用止痛药物、干预部位有皮肤病、胎儿窘迫、出血、发热以及不同意参与研究。在分娩的第一阶段，在腰背部和下腹部间歇性使用热敷袋和冷敷袋，在第二阶段在会阴部位使用。采用视觉模拟评分法评估疼痛强度。使用描述性统计、卡方检验和t检验进行数据分析。 结果：两组在人口统计学和助产特征以及基线疼痛方面无显著差异。干预组在分娩的第一阶段和第二阶段疼痛明显较低。病例组第一产程和第三产程的持续时间较短。两组在分娩方式、会阴裂伤、缩宫素使用、胎儿心率和阿氏评分方面无显著差异。 讨论：间歇性冷敷袋局部温热可减轻分娩疼痛，且对母婴结局无不良影响。这是一种廉价且简单的方法。 结论：间歇性局部热冷疗法是一种非药物、安全有效的缓解分娩疼痛的方法。
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