Journal of midwifery & women's health
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J Midwifery Womens Health · Nov 2004
ReviewThe neuromatrix theory of pain: implications for selected nonpharmacologic methods of pain relief for labor.
Women experience the pain of labor differently, with many factors contributing to their overall perception of pain. The neuromatrix theory of pain provides a framework that may explain why selected nonpharmacologic methods of pain relief can be quite effective for the relief of pain for the laboring woman. The concept of a pain "neuromatrix" suggests that perception of pain is simultaneously modulated by multiple influences. ⋯ Wall. This article reviews several nonpharmacologic methods of pain relief with implications for the practicing clinician. Providing adequate pain relief during labor and birth is an important component of caring for women during labor and birth.
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J Midwifery Womens Health · Nov 2004
ReviewUpdate on nonpharmacologic approaches to relieve labor pain and prevent suffering.
The control of labor pain and prevention of suffering are major concerns of clinicians and their clients. Nonpharmacologic approaches toward these goals are consistent with midwifery management and the choices of many women. We undertook a literature search of scientific articles cataloged in CINAHL, PUBMED, the Cochrane Library, and AMED databases relating to the effectiveness of 13 non-pharmacologic methods used to relieve pain and reduce suffering in labor. ⋯ Acupuncture, massage, transcutaneous electrical nerve stimulation, and hypnosis are promising, but they require further study. The effectiveness of childbirth education, relaxation and breathing, heat and cold, acupressure, hypnosis, aromatherapy, music, and audioanalgesia are either inadequately studied or findings are too variable to draw conclusions on effectiveness. All the methods studied had evidence of widespread satisfaction among a majority of users.
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A baseline assessment of pain should occur as part of a newborn's health assessment within the first few hours of life. Validation and assessment of pain in the term newborn is important for providing care because newborns may experience pain from a multitude of procedures, ranging from heel sticks to circumcisions. ⋯ In addition, providing individualized care requires a knowledge base of the interventions available to reduce or eliminate pain, such as breastfeeding, non-nutritive suck, skin-to-skin contact, and sucrose pacifiers. This article describes three newborn pain assessment tools, the use of valid assessment tools, and evidence-based interventions that are recommended to effectively manage newborn pain.
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This article is a review of analgesics and anesthetics offered to laboring women, including intravenous drugs, epidural and spinal agents, and inhalational anesthetics. An overview of the uses, risks, and benefits is provided for each anesthetic alternative. To provide the most effective care to women in labor, clinicians have a responsibility to have current knowledge of the best evidence for safety and efficacy of these pharmacologic agents and techniques and be able to effectively communicate this information to clients.