Use of acupressure with breathing technique and relaxation for pain relief in labor

INTERVENTION: D000529 D019050 Experimental group: 52 women were instructed to perform during labor, slow and deep breathing during contractions, in between the contractions, release of all body muscles associated with slow thoracoabdominal breathing in a natural rhythm. This group applied pressure with the thumb of medium intensity (± 5kg to 15kg ) on the Sanyinjiao point (SP6) in both legs during the contractions, in a period of 20 minutes. Placebo group: 52 women were instructed to perform during labor, slow and deep breathing during contractions, in between the contractions, release of all body muscles associated with slow thoracoabdominal breathing in a natural rhythm.This group was applied pressure with the thumb of low intensity (± 100g) with the thumb on the Sanyinjiao point (SP6) on both legs. Control group: 52 women were instructed to perform during labor, slow and deep breathing during contractions, in between the contractions, release of all body muscles associated with slow thoracoabdominal breathing in a natural rhythm. CONDITION: C10.597.617.515 G08.686.785.760.769.326 Labor, Obstetric, Labor pain ; C10.597.617.515 ; G08.686.785.760.769.326 O00‐O99 PRIMARY OUTCOME: Pain control during labor according to the visual analog scale (VAS) graded from 0 to 10, 0 for complete absence of pain and 10 being the worst pain experienced, assessed before, 20 and 60 minutes of treatment. The average pain score was not different among the three groups at baseline (p=0.098). However, a difference was seen immediately after acupressure (SP6 5.92 ± 2.29 versus placebo 7.60 ± 2.47 versus control 8.50 ± 1.90, p<0.001) and at 60 minutes of treatment (SP6 6.47 ± 2.21 versus placebo 8.09 ± 2.25 versus control 8.75 ± 1.82, p<0.001). These differences were significantly different between groups. SECONDARY OUTCOME: The duration of labor was significantly different between the SP6 acupressure group [221.5 min (± 162.4 min)] versus placebo [397.9 min (± 265.6 min)] and versus control [381.9 min (± 358.3) min)] (p=0.005); the groups were similar regarding the cesarean section raterates (p=0.255); there was no difference between the Apgar scores in the first minute (p=0.954) and fifth minute (SP6 9.62 versus placebo 9.54 versus control 9.29, p=0.722); use of intravenous or intramuscular analgesic, epidural anesthesia or combined blockade showed no statistical difference (p=0.584) during study. Time of labor; cesarean delivery rate; Apgar in the first and fifth minute of the newborn; use of analgesics and analgesia. INCLUSION CRITERIA: 156 women in labor; 37 weeks gestation or more; single and cephalic fetus; cervical dilation greater than or equal to 4 cm; two or more contractions in 10 minutes; skin integrates on acupressure point.