ISSN : 2146-3123
E-ISSN : 2146-3131

Effects of Intradermal Sterile Water Injections in Women with Low Back Pain in Labor: A Randomized, Controlled, Clinical Trial
Refika Genç Koyucu1, Nurdan Demirci2, Ayşe Ender Yumru3, Süleyman Salman4, Yavuz Tahsin Ayanoğlu4, Yıldız Tosun4, Cihangir Tayfur5
1Department of Maternity and Gynecology Nursing, Beykent University School of Medicine, İstanbul, Turkey
2Department of Maternity and Gynecology Nursing, Marmara, University School of Medicine, İstanbul, Turkey
3Clinic of Maternity and Gynecology, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
4Clinic of Obstetric and Gynecology, Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
5Esenyurt State Hospital, İstanbul, Turkey
DOI : 10.4274/balkanmedj.2016.0879

Background: In addition to pain caused by uterine contractions in labor, continuous and severe back pain is observed in 33% of women. Several pharmacological and nonpharmacological methods are available for managing this pain. Sterile water injection is considered to be an alternative method for nonpharmacological management.
Aim: The aim of this study was to assess the satisfaction level and effectiveness of sterile water injection for back pain among women in labor.
Study Design: This was a randomized controlled trial.
Methods: A total of 168 term, healthy women with labor pain and severe back pain were randomized into 4× 0.1 mL of sterile water (study) and 4× dry injection (placebo) groups. Injections were applied to the rhombus of Michaelis in the sacral area. Pain scores were assessed at 10, 30, 60, 120, and 180 min with the visual analog scale. Additionally, the need for epidural analgesia, Apgar score, mode of delivery, time of delivery, maternal satisfaction, and breastfeeding scores were all assessed.
Results: The mean back pain scores at 30 min after injections were significantly lower in the study group (study group: 31.66 ± 11.38; placebo: 75 ± 18.26, P < 0.01). The mean decrease in pain scores after 30 min according to baseline was significantly higher in the study group (study group: 54.82; placebo: 13.33 ± 12.05, P < 0.01). The need for epidural analgesia, time of delivery, mode of delivery, and Apgar and breastfeeding scores were similar in both groups. Maternal satisfaction from the analgesic effect was significantly higher in the study group (study group 84.5%, placebo 35.7%, P < 0.01).
Conclusion: The application of sterile water injection is effective in relieving back pain in the first stage of labor and has a sufficient satisfaction level among women.

Keywords : Sterile water Injection, Labor, Labor pain, Back pain, Obstetrical Analgesia, Midwifery
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