Non Narcotic Pain Relief in Postcaesarean Women by Percutaneous Stimulation of Auricular Pressure Points: A Randomised Controlled Study

Abstract

Introduction: Caesarean sections are the most common surgeries performed globally now-a-days. The postoperative period is associated with immense pain which if not mitigated can be detrimental to both mother and baby. An inadequate analgesia can lead to postpartum depression, and can also affect mother-baby bonding, breastfeeding including delay in ambulation. Aim: To assess the efficacy of non narcotic pain relief and to study the additional need of rescue analgesics. Materials and Methods: A randomised controlled study was carried out at the Institute of Social Obstetrics and Government Kasturba Gandhi Hospital after registering with Clinical Trials Registry-India CTRI/2022/04/041633. A total of 60 antenatal women undergoing caesarean section under spinal anaesthesia were randomly allocated into two groups of 30 each. Group P received stimulation of auricular pressure points with a stimulation device at the end of caesarean procedure and Group C was a control group. The cases were monitored for 48 hours, and the following parameters were recorded: spinal regression time, pain score Visual Analogue Scale (VAS), rescue analgesic need including time and total dosage, sedation scores using the modified Ramsay sedation scale and postoperative nausea and vomiting. Data analysis was done using International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) software version 23.0. Data was expressed as mean±Standard Deviation (SD). Quantitative analysis was done using Pearson’s Chi-square test and Independent t-test. A p-value of <0.05 was considered significant. Results: Group P had VAS scores 2.53±0.64 and Group C had VAS scores 4.97±0.47 with highly significant p-value of <0.001. Only 2 (7%) of patients in Group P needed rescue analgesic whereas all patients of Group C required rescue analgesic with highly significant p-value of 0.001. Postoperative nausea vomiting was noted in only 1 (3%) patient of Group P as opposed to 12 patients (40%) in Group C with highly significant p-value <0.001. Group P showed maximum sedation score of two as compared to three in Group C as assessed by Modified Ramsay Sedation scale with statistically significant p-value of 0.01. Conclusion: The percutaneous stimulation of auricular pressure points is efficacious in providing good analgesia with early ambulation, breastfeeding, and no adverse effects.

Keywords

• analgesia
• auriculotherapy
• caesarean section
• non opioid analgesics