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不同减轻分娩疼痛策略的效果：贝叶斯分析。

Efficacy of different strategies for reducing labor pain: A Bayesian analysis.

机构信息

Obstetrical Department, SSL Central Hospital of Dongguan City, Dongguan, Guangdong Province, China.

出版信息

Medicine (Baltimore). 2024 May 17;103(20):e37594. doi: 10.1097/MD.0000000000037594.

DOI:10.1097/MD.0000000000037594
PMID:38758902
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11098187/
Abstract

BACKGROUND

The effectiveness of different medical interventions in managing labor pain has yielded mixed results. Therefore, this systematic review and network meta-analysis aimed to provide a comprehensive summary of the available evidence on the impact of different strategies for reducing labor pain.

METHODS

We systematically searched 3 English databases (Pubmed, Embase and the Cochrane Library) from inception to January 2023. Randomized controlled trials (RCTs) or controlled clinical trials that investigating the effects of different strategies for reducing labor pain were included in this network meta-analysis. Risk of bias (ROB) was assessed using the Cochrane ROB tools. Network meta-analysis was performed using the R software (version 4.2.1) with gemtc package.

RESULTS

A total of 9 studies involving 823 patients, including 9 treatments (acupressure, birth ball exercise, Bonapace method, distraction techniques, ice pressure, LI4 acupressure, lidocaine spray, smartphone-based music intervention and placebo). The surface under the cumulative ranking (SUCRA) shows that Bonapace method ranked first (SUCRA, 79.5%), LI4 acupressure ranked second (SUCRA, 65.6%), distraction technique ranked third (SUCRA, 57.6%), birth ball exercise ranked fourth (SUCRA, 51.8%).

CONCLUSIONS

According to the results of the network meta-analysis, among the different strategies examined, the Bonapace Method stands out as the most effective nonpharmacological intervention for reducing labor pain. The results of this meta-analysis can aid both patients and healthcare professionals in choosing the most effective techniques to reduce labor pain.

摘要

背景

不同医学干预措施在管理分娩疼痛方面的有效性结果不一。因此，本系统评价和网络荟萃分析旨在全面总结现有关于不同减轻分娩疼痛策略影响的证据。

方法

我们系统地检索了 3 个英文数据库（Pubmed、Embase 和 Cochrane Library），检索时间从建库至 2023 年 1 月。本网络荟萃分析纳入了评估不同减轻分娩疼痛策略效果的随机对照试验（RCT）或对照临床试验。使用 Cochrane ROB 工具评估偏倚风险（ROB）。使用 R 软件（版本 4.2.1）和 gemtc 包进行网络荟萃分析。

结果

共有 9 项研究纳入 823 名患者，包括 9 种治疗方法（穴位按压、分娩球运动、Bonapace 法、分散注意力技术、冰敷、LI4 穴位按压、利多卡因喷雾、基于智能手机的音乐干预和安慰剂）。累积排序概率曲线下面积（SUCRA）显示 Bonapace 法排名第一（SUCRA，79.5%），LI4 穴位按压排名第二（SUCRA，65.6%），分散注意力技术排名第三（SUCRA，57.6%），分娩球运动排名第四（SUCRA，51.8%）。

结论

根据网络荟萃分析的结果，在所检查的不同策略中，Bonapace 法是非药物干预减轻分娩疼痛最有效的方法。本荟萃分析的结果可以帮助患者和医疗保健专业人员选择最有效的减轻分娩疼痛的技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cb3/11098187/228781255277/medi-103-e37594-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cb3/11098187/fbf8567445c0/medi-103-e37594-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cb3/11098187/5240834001a8/medi-103-e37594-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cb3/11098187/75a0f93652bc/medi-103-e37594-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cb3/11098187/ed5fd815e149/medi-103-e37594-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cb3/11098187/2908e32008e3/medi-103-e37594-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cb3/11098187/6b04980a3c74/medi-103-e37594-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cb3/11098187/228781255277/medi-103-e37594-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cb3/11098187/fbf8567445c0/medi-103-e37594-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cb3/11098187/5240834001a8/medi-103-e37594-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cb3/11098187/75a0f93652bc/medi-103-e37594-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cb3/11098187/ed5fd815e149/medi-103-e37594-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cb3/11098187/2908e32008e3/medi-103-e37594-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cb3/11098187/6b04980a3c74/medi-103-e37594-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cb3/11098187/228781255277/medi-103-e37594-g007.jpg

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本文引用的文献

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The effectiveness of aromatherapy in the management of labor pain: A meta-analysis.芳香疗法在分娩疼痛管理中的有效性：一项荟萃分析。
Eur J Obstet Gynecol Reprod Biol X. 2023 Oct 18;20:100255. doi: 10.1016/j.eurox.2023.100255. eCollection 2023 Dec.
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