Journal of Traditional Medical Complementary Therapies

.: REVIEW
Doğum Ağrısının Yönetiminde Akupunkturun Etkinliği: Sistematik Derleme
Acupuncture Activity in the Management of Labor Pain: A Systematic Review
Birnur YEŞİLDAĞa , Zehra GÖLBAŞIb
aSivas Cumhuriyet Üniversitesi Suşehri Sağlık Yüksekokulu, Hemşirelik Bölümü, Sivas, Türkiye
bLokman Hekim Üniversitesi Sağlık Bilimleri Fakültesi, Hemşirelik Bölümü, Ankara, Türkiye
J Tradit Complem Med. 2024;7(1):92-9
doi: 10.5336/jtracom.2023-100142
Article Language: TR
Full Text
ÖZET
 Şiddetli akut ağrıların içinde yer alan doğum ağrısı, uygun girişimlerle yönetilmediği zaman vajinal doğum eyleminde maternal ve fetal sağlık üzerine olumsuz etkiye neden olabilmektedir. Bu nedenle doğum ağrısının yönetiminde farmakolojik ve nonfarmakolojik yöntemler kullanılmaktadır. Günümüzde sıklıkla kullanılan nonfarmakolojik yöntemlerden birini akupunktur uygulaması oluşturmaktadır. Akupunktur uygulamasının doğum ağrısı üzerine etkisini değerlendiren çalışmalarda elde edilen sonuçlarda çelişkiler bulunmaktadır. Bu nedenle bu sistematik derlemede, doğum ağrısının yönetiminde akupunkturun etkinliğini inceleyen çalışmalara ilişkin bir değerlendirmede bulunmak amaçlanmıştır. Araştırmada arama motoru olarak PubMed veri tabanı kullanılmıştır. 10-20 Eylül 2023 tarihleri arasında yıl sınırlaması yapılmadan ''akupunktur'', ''doğum ağrısı'', ''ağrı yönetimi'' anahtar kelimeleri ile 193 makaleye ulaşılmıştır. Doğum ağrısını azaltmada akupunkturun etkinliğini değerlendiren, 38-42 gebelik haftasında olan, vajinal doğum yapmada engeli olmayan, doğum ağrısı yönetiminde akupunktur uygulamasını kullanan, tam metnine ulaşılabilen randomize kontrollü çalışmalar irdelenmiş ve 7 makale çalışma kapsamına alınmıştır. İnceleme kapsamına alınan çalışmalarda; akupunktur, manuel akupunktur, elektroakupunktur, Sham akupunktur kullanılmıştır. Dâhil edilen çalışmalarda, akupunktur uygulama süreleri ve akupunktur uygulama noktalarının değişkenlik gösterdiği belirlenmiştir. Çalışmalarda ağrı değerlendirme aracı olarak çoğunlukla görsel analog skala kullanılmıştır. Çalışma bulgularında elde edilen sonuçlara göre sadece elektroakupunktur uygulamasının doğum ağrısı üzerine analjezik etkisinin yeterli olduğu bulunmuştur. Randomize kontrollü çalışmalardan elde edilen sonuçlar doğum ağrısı kontrolünde akupunktur uygulamasının analjezik etkisinin yetersiz olduğunu ortaya koymaktadır.

Anahtar Kelimeler: Akupunktur; doğum ağrısı; ağrı yönetimi; hemşirelik/ebelik
ABSTRACT
 When labor pain, which is among the severe acute pains, is not managed with appropriate interventions, it can cause negative effects on maternal and fetal health during vaginal birth. For this reason, pharmacological and non-pharmacological methods are used in the management of labor pain. Acupuncture is one of the non-pharmacological methods frequently used today. There are contradictions in the results obtained in studies evaluating the effect of acupuncture on labor pain. Therefore, this systematic review aimed to make an evaluation of the studies examining the effectiveness of acupuncture in the management of labor pain. 193 articles were reached in the PubMed database using the keywords ''acupuncture'', ''labor pain'' and ''non-pharmacological methods'' without year limitation between September 10 and 20, 2023. Randomized controlled studies that evaluated the effectiveness of acupuncture in reducing labor pain, those who were 38-42 weeks of gestation, who had no obstacle to vaginal birth, and who used acupuncture in labor pain management, whose full text was available, were examined and seven articles were included in the study. Acupuncture, manual acupuncture, electroecupuncture, and Sham acupuncture were used in the studies included in the review. It was determined that acupuncture application times and acupuncture application points varied in the included studies. Visual analogue scale was mostly used as a pain assessment tool in studies. According to the results obtained in the study findings, it was found that only the analgesic effect of electroacupuncture application on labor pain was sufficient. Randomized controlled trials examining the effect of acupuncture on labor pain from nonpharmacologic methods at birth suggest that the analgesic effect of acupuncture is inadequate in the control of labor pain.

Keywords: Acupuncture; labor pain; pain management; nursing/midwifery
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