title: Pain relief by applying transcutaneous electrical nerve stimulation (TENS) on acupuncture points during the first stage of labor: a randomized double-blind placebo-controlled trial.
abstract: Transcutaneous electrical nerve stimulation (TENS) is one of the non-pharmacological means of pain relief for labor and delivery. We aimed to investigate the efficacy and safety of TENS on specific acupuncture points for reducing pain in the first stage of labor. In this double-blind, placebo-controlled trial, we randomly assigned healthy full-term parturients in active phase of first-stage labor to either TENS on four acupuncture points (Hegu [Li 4] and Sanyinjiao [Sp 6]) (n=52) or the TENS placebo (n=53). Visual analogue scale (VAS) was used to assess pain before and 30 and 60 min after treatment. The primary outcome was the rate of VAS score decrease 3 in each group. A questionnaire was given at 24h post-partum to evaluate the satisfaction of pain relieving method and the willingness to have the same treatment again. Mode of delivery and neonatal effect were measured as secondary outcome. One hundred women were eligible for analysis. TENS group experienced VAS score reduction 3 significantly more common than the TENS placebo group (31/50 [62%] vs 7/50 [14%], P<0.001). Willingness of using the same analgesic method for a future childbirth was also significantly different (TENS: 48/50 [96%] vs TENS placebo: 33/50 [66%], P<0.001). Operative delivery was increased in the TENS group (12/50 [24%] vs 4/50 [8%], P=0.05), but the neonatal outcomes were not different. The application of TENS on specific acupuncture points could be a non-invasive adjunct for pain relief in the first stage of labor.
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taiwan Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan Graduate Institute of Basic Medical Sciences, Chang Gung University, Taiwan Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: An-Shine
authors.initials: AS
authors.lastname: Chao
authors.forename: Angel
authors.initials: A
authors.lastname: Chao
authors.forename: Tzu-Hao
authors.initials: TH
authors.lastname: Wang
authors.forename: Yu-Cheng
authors.initials: YC
authors.lastname: Chang
authors.forename: Hsiu-Huei
authors.initials: HH
authors.lastname: Peng
authors.forename: Shuenn-Dyh
authors.initials: SD
authors.lastname: Chang
authors.forename: Anne
authors.initials: A
authors.lastname: Chao
authors.forename: Chee-Jen
authors.initials: CJ
authors.lastname: Chang
authors.forename: Chyong-Huey
authors.initials: CH
authors.lastname: Lai
authors.forename: Alice M K
authors.initials: AMK
authors.lastname: Wong
mesh_terms: D015667:Acupuncture Analgesia / Q000379:methods*; D015669:Acupuncture Points; D000328:Adult; D016362:Analgesia, Obstetrical / Q000379:methods; D004311:Double-Blind Method; D015671:Electroacupuncture / Q000379:methods*; D005260:Female; D006801:Humans; D048949:Labor Pain / Q000175:diagnosis* / Q000628:therapy*; D010147:Pain Measurement; D015990:Placebo Effect; D011247:Pregnancy; D016896:Treatment Outcome