Title : The role of acupoint stimulation in post-cesarean pain management: A meta-analysis
Abstract:
Background: Acupoint stimulation has been widely used in clinical practice, but its effectiveness in managing post-cesarean pain remains controversial. This study aims to clarify this issue by providing a more comprehensive evaluation of its impact on acute postoperative pain in women undergoing elective cesarean sections.
Methods: A meta-analysis of randomized sham-controlled trials was conducted. Comprehensive searches were performed in PubMed, Embase, Web of Science, Scopus, Cochrane Library, and China National Knowledge Infrastructure (CNKI) from their inception to October 10, 2024. A randomeffects model was used to estimate the mean difference (MD), standardized mean difference (SMD), and risk ratio (RR) with corresponding 95% confidence intervals (CI).
Results: Ten trials with 1,198 participants were included. Regarding the risk of bias, eight trials were considered to have a low risk of bias, while the remaining two were rated as having some concerns due to issues with the randomization process. Compared to the sham group, the acupoint stimulation group had lower pain scores within 6 hours (MD: -0.23; 95% CI: -0.44 to -0.02), 6-12 hours (MD: -0.52; 95% CI: -0.97 to -0.07), and 12-24 hours (MD: -0.47; 95% CI: -0.78 to -0.16). However, there was no difference at 24-48 hours (MD: -0.31; 95% CI: -0.73 to 0.11). In addition, acupoint stimulation showed no significant difference in the risk of nausea (RR = 0.38; 95% CI: 0.05 to 3.12) and vomiting (RR = 0.49; 95% CI: 0.16 to 1.53) compared to the sham group. By managing pain, acupoint stimulation could help facilitate early maternal mobilization and enhance uterine contraction. Additionally, acupoint stimulation could support breastfeeding by improving maternal comfort, reducing stress, and strengthening the bond with the newborn.
Conclusion: Acupoint stimulation effectively reduces post-cesarean pain compared to sham groups. Hospitals where acupoint stimulation is available should offer it as part of routine care for parturients. However, the optimal starting point, duration, and specific techniques still require further investigation.
