背景:孕妇的分娩疼痛差异很大,从温和到极度痛苦。阴道分娩期间的非药理学疼痛缓解方法越来越受欢迎,作为药物的补充或有时作为缓解疼痛的主要方法。多项试验报道,手动或手动按摩可减少分娩疼痛。使用电动按摩椅进行全身机械按摩对分娩疼痛的有效性仍未探索。
目的:评价电动按摩椅机械按摩对未产妇分娩疼痛的影响。
方法:于2022年8月至2023年2月在马来西亚一所大学医院进行了一项随机平衡交叉试验。纳入最低分娩疼痛评分为5(0-10数字评定量表)的符合条件的无产妇。参与者被随机分配到机械按摩的按摩椅上30分钟,然后在没有机械按摩的按摩椅上30分钟。或者按摩顺序相反。主要结果是疼痛评分的变化,比较有和没有机械按摩的疼痛,作为整个试验参与者的配对比较。次要结局是产妇和新生儿结局的跨组分析。配对t检验,t测试,曼恩-惠特尼U测试,适当地对数据使用卡方检验和Fisher精确检验。
结果:208名女性被随机分配,每个干预104名。数据来自204名参与者(103名随机选择先按摩,101名随机选择先不按摩)。分娩疼痛评分变化的主要结果(0-10数字评定量表,NRS)在按摩和无按摩后(交叉后包括所有参与者,配对t检验分析)为平均值±标准差4.51±2.3vs5.38±2.1平均差-0.87(95%CI-1.14至-0.59),p<0.001,电椅机械按摩后的疼痛评分与不按摩相比显著降低。在随机分组的二次分析中,首次使用按摩椅后的分娩疼痛评分为4.35±2.52(随机分为先按摩,接受按摩作为初始干预)与5.66±1.73p<0.001(随机分组,先不接受按摩,没有接受按摩作为初始干预)平均差-1.31(95%CI-1.91至-0.748),机械按摩后明显减少。其他远端产妇结局(分娩方式,分娩镇痛,分娩时间和产妇同意机械按摩对分娩疼痛有效)和新生儿结局(1分钟和5分钟时的Apgar评分,脐带血pH和碱过量,和新生儿入院)在随机分组中没有差异。
结论:使用电动按摩椅进行机械按摩可显着减轻分娩疼痛,提供分娩期间潜在的非药理学疼痛管理选择。
Labor pain varies significantly among pregnant women, ranging from mild to extremely distressing. Nonpharmacologic pain relief methods during vaginal birth are increasingly popular, either as a complement to pharmacologic agents or, at times, as the primary method of pain relief. Multiple trials have reported that manual or by-hand massage reduces labor pain. The effectiveness of full-body mechanical massage using electric massage chairs on labor pain remains unexplored.
This study aimed to evaluate mechanical massage using an electric massage chair on labor pain in nulliparous women.
A randomized counterbalanced crossover trial was conducted in a university hospital in Malaysia from August 2022 to February 2023. Eligible nulliparas in labor with a minimum labor pain score of 5 (0-10 numerical rating scale) were enrolled. Participants were randomized to 30 minutes on the massage chair with mechanical massage followed by 30 minutes on the massage chair without mechanical massage or the other way around in the massage sequence. The primary outcome was a change in pain score comparing pain with and without mechanical massage as a paired comparison for the entire trial participants. The secondary outcomes were across arms analyses of maternal and neonatal outcomes. The paired t test, t test, Mann-Whitney U test, chi-square test, and Fisher exact test were used as appropriate for the data.
Overall, 208 women were randomized: 104 to each intervention. Data were available from 204 participants (103 randomized to massage first and 101 to no massage first). The primary outcomes of change in labor pain scores (0-10 numerical rating scale) after massage and no massage (all participants included after crossover, paired t test analysis) were 4.51±2.30 and 5.38±2.10, respectively (mean difference, -0.87; 95% confidence interval, -1.14 to -0.59; P<.001), a significant reduction in pain score after electric chair mechanical massage compared with no massage. On the across randomized arms secondary analyses, labor pain scores after their first massage chair session were 4.35±2.52 (randomized to massage first, received massage as initial intervention) and 5.66±1.73 (randomized to no massage first, received no massage as initial intervention) (mean difference, -1.31; 95% confidence interval, -1.91 to -0.748; P<.001), a significant reduction after mechanical massage. Other distal maternal outcomes (mode of delivery, labor analgesia, duration of labor, and maternal agreement that mechanical massage is effective for labor pain) and neonatal outcomes (Apgar scores at 1 and 5 minutes, cord artery blood pH and base excess, and neonatal admission) were not different across randomized arms.
Mechanical massage using an electric massage chair significantly reduced labor pain, offering a potential nonpharmacologic pain management option during labor.