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经皮神经电刺激在第一产程中的作用:一项随机对照试验。

The effects of transcutaneous electrical nerve stimulation during the first stage of labor: a randomized controlled trial.

机构信息

Xiangya School of Nursing, Central South University, Changsha, China.

Department of Nursing, Hunan Provincial People's Hospital, the First Affiliated Hospital of Hunan Normal University, Changsha, China.

出版信息

BMC Pregnancy Childbirth. 2021 Feb 24;21(1):164. doi: 10.1186/s12884-021-03625-8.

Abstract

BACKGROUND

Labor pain during childbirth can have devastating effects on the progress of labor, mother, and fetus. Consequently, the management of labor pain is crucial for the well-being of the mother and fetus. Transcutaneous electrical nerve stimulation (TENS) is a non -pharmacological analgesic technique. It uses a low-voltage electrical current to activate descending inhibitory systems in the central nervous system to relieve pain. This study aimed to determine the effects of TENS therapy in the first stage of labor.

METHODS

In this single-blind randomized controlled trial, we screened low-risk pregnant women who anticipated spontaneous vaginal delivery. Women were assigned (1:1) to either the experimental group (received TENS therapy in the first stage of labor) or the control group (received routine obstetric care). The women, midwives, and researchers working in the gynecology and obstetric department were aware of the treatment group, but statisticians analysis the data were blinded. The primary outcome was labor pain intensity, assessed by visual analog scale (VAS) immediately after the randomization, at 30, 60, and 120 min after TENS therapy, and 2-24 h post-delivery. We used SPSS 21.0 software in data analysis. An independent sample t-test compared the mean VAS scores and labor duration between groups. A Chi-square test was employed to compare categorical variables between the groups. A significant level of ≤0.05 was statistically significant.

RESULTS

A total of 326 pregnant women were eligible: experimental group (n = 161) and control group (n = 165). The experimental group had statistically significantly lower mean VAS scores at a different time (30, 60, and 120 min post-intervention and 2-24 h post-delivery) than the control group (p < 0.001). The experimental group demonstrated a statistically significant shorter duration of the active labor phase than the control group (p < 0.001).

CONCLUSION

This study indicates that TENS can be used as a non-pharmacological therapy to reduce pain and shorten the active labor phase.

TRIAL REGISTRATION

ISRCTN registry, ISRCTN23857995 . Registered on 11/12/2020, 'retrospectively registered.

摘要

背景

分娩时的疼痛会对分娩进程、产妇和胎儿产生破坏性影响。因此,管理分娩疼痛对于产妇和胎儿的健康至关重要。经皮神经电刺激(TENS)是一种非药物性镇痛技术。它使用低电压电流来激活中枢神经系统中的下行抑制系统,以缓解疼痛。本研究旨在确定 TENS 疗法在分娩第一阶段的效果。

方法

在这项单盲随机对照试验中,我们筛选了预计自然阴道分娩的低风险孕妇。将妇女(1:1)随机分配到实验组(分娩第一阶段接受 TENS 治疗)或对照组(接受常规产科护理)。妇产科的妇女、助产士和研究人员都知道治疗组,但进行数据分析的统计人员是盲法的。主要结局是通过视觉模拟量表(VAS)评估的分娩疼痛强度,在随机分组后立即、TENS 治疗后 30、60 和 120 分钟以及分娩后 2-24 小时进行评估。我们使用 SPSS 21.0 软件进行数据分析。独立样本 t 检验比较组间 VAS 评分和产程的均值。采用卡方检验比较组间的分类变量。统计学显著性水平≤0.05。

结果

共有 326 名孕妇符合条件:实验组(n=161)和对照组(n=165)。实验组在不同时间(干预后 30、60 和 120 分钟以及分娩后 2-24 小时)的平均 VAS 评分均显著低于对照组(p<0.001)。实验组的活跃分娩阶段持续时间明显短于对照组(p<0.001)。

结论

本研究表明,TENS 可作为一种非药物治疗方法,减轻疼痛并缩短活跃分娩阶段。

试验注册

ISRCTN 注册处,ISRCTN23857995。于 2020 年 12 月 11 日注册,“回顾性注册”。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21d1/7905652/a23a9cb72e4b/12884_2021_3625_Fig1_HTML.jpg

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