Background

Optimizing analgesia following caesarean section is essential for improving maternal rehabilitation and fostering maternal-infant bonding.

Objective

The purpose of this study was to evaluate the safety and effectiveness of transcutaneous electrical acupoint stimulation (TEAS) combined with press needle therapy as an adjunctive approach for postoperative pain control following caesarean section.

Design, setting, participants and interventions

One hundred women with singleton term pregnancies who were schedule to undergo caesarean section births under combined spinal-epidural anesthesia were recruited. Patients were randomly assigned to the acupuncture group (n = 50) or sham-acupuncture group (n = 50). The acupuncture group received pre- and intraoperative TEAS combined with postoperative press needle therapy. The sham-acupuncture group received a sham acupuncture intervention.

Main outcome measures

The primary outcome was total cumulative morphine consumption at 48 h. Secondary outcomes included pain scores, morphine consumption and patient satisfaction. Analgesic-related adverse effects and acupuncture-related side effects were recorded.

Results

Overall, 100 patients were included in the intention-to-treat analysis. Median (interquartile range [range]) of cumulative morphine consumption at 48 h in the acupuncture group was lower than that in the sham-acupuncture group (22.9 [16.9–28.9] mg vs 34.9 [22.4–39.4] mg), with an estimated median difference of –10.0 mg (95% confidence interval, [–14.0, –4.0]; P < 0.001). The generalized estimating equation analysis also revealed that cumulative morphine consumption was significantly lower in the acupuncture group than in the sham-acupuncture group at 6, 12 and 24 h (P < 0.001). In addition, patients in the acupuncture group reported lower pain scores both at rest and during movement at 6, 12 and 24 h compared to those in the sham-acupuncture group (P < 0.001). Furthermore, acupuncture improved patient satisfaction (P < 0.001) and decreased the incidence of nausea and vomiting after surgery (12% vs 30%; P = 0.03). None of the patients in the study experienced any acupuncture-related side effects.

Conclusion

As a non-pharmacological approach, TEAS combined with press needle therapy safely and effectively reduced postoperative morphine consumption and alleviated postoperative pain in women who underwent caesarean section births, recommending it as a routine complementary treatment for postpartum analgesia.

Trial registration

The protocol was registered at the Chinese Clinical Trial Registry (ChiCTR2400086645).

Key words: Acupuncture, Transcutaneous electrical acupoint stimulation, Caesarean section, Press needle therapy, Acute pain, Randomized controlled trial