Efficacy of aromatherapy for reducing pain during labor: a randomized controlled trial

Effects of Rosa damascena on Labor Pain and Anxiety in Primiparous Women

This study aimed to investigate the effect of Damask rose aromatherapy on pain and anxiety in primiparas during the incubation and latent periods of the first stage of labor. The study randomly divided participants into aroma, placebo, and control groups. The control group received daily care, while the aroma group received at least 30 minutes of aromatherapy. The placebo group received the same aromatherapy device as the aroma group but inhaled saline. Pain, anxiety, and uterine contractions were measured at enrollment and at 30, 60, and 120 minutes. Data from 76 participants were analyzed, and the results showed that the aroma group had lower anxiety and pain scores than the placebo and control groups at 60 and 120 minutes. Additionally, the effect gradually appeared and was maintained even with increased contractions. Damask rose aromatherapy can be used as a safe and effective adjuvant therapy for reducing the anxiety and pain of women in the latent period of labor.

The effect of aromatherapy massage with lemon and peppermint essential oil on menopausal symptoms: A double-blinded, randomized placebo controlled clinical trial

OBJECTIVES

Menopausal and postmenopausal women experience many physical and psychological symptoms. The positive effects of aromatherapy sessions with different oils on menopausal symptoms are well known. The aim of this study was to investigate the effect of an aromatherapy massage with peppermint and lemon essential oil on menopausal symptoms.

METHODS

Total 63 menopausal and postmenopausal women were included in this study. Participants were randomly divided into three groups: Menta peppermint (n = 21), Citrus lemon (n = 21), and Placebo (n = 21). The peppermint and lemon essential oils of the intervention groups were diluted with 1.5 % sweet almond oil. Pure sweet almond oil was used in the placebo group. Each participant in the massage groups received a hand and arm massage with the selected oil twice a week for 4 weeks in 30-min sessions. Participants' menopausal symptoms were assessed before and after application using the Menopause Symptoms Rating Scale (MRS).

RESULTS

When the differences in the treatment groups according to time were examined, it was found that there were statistically significant differences in lemon (F = 9.561, p = 0.003, η2 = 0.139) and peppermint essential oil (F = 15.687, p = 0.001, η2 = 0.210) groups according to time. The peppermint essential oil group was more effective than the lemon group. In addition, both peppermint and lemon essential oils were effective for somatic symptoms (p < 0.05). For psychological symptoms, only the lemon oil (p = 0.011) proved effective, and for urogenital symptoms, only the peppermint essential oil (p = 0.001).

CONCLUSION

The study found that aromatherapy massage with peppermint and lemon essential oil effectively reduced menopausal symptoms. Peppermint essential oil was more effective than lemon essential oil in reducing the menopausal symptoms.

THE CLINICAL TRIAL REGISTRATION NUMBER

NCT05677698.

Effects of aromatherapy on patient satisfaction with procedural abortion at less than 10 weeks' gestation: A randomized controlled trial

OBJECTIVES

This study aimed to compare satisfaction with procedural abortion prior to 10 weeks' gestation in patients randomized to lavender essential oil aromatherapy vs placebo (jojoba oil).

STUDY DESIGN

This randomized trial compared lavender aromatherapy vs placebo in patients undergoing procedural abortion <10 weeks' gestation. Participants self-administered and inhaled oil during their procedures. Our primary outcome was composite mean score on the Iowa Satisfaction with Anesthesia Scale. Participants completed the State-Trait Anxiety Inventory, a visual analog scale reporting maximum procedural pain, and reported postprocedure aromatherapy acceptability.

RESULTS

We analyzed 112 participants randomized to aromatherapy (n = 57) vs placebo (n = 55). Baseline characteristics were similar between groups. We found no difference in overall satisfaction (mean Iowa Satisfaction with Anesthesia Scale scores aromatherapy: 0.72 ± 0.96 vs placebo: 0.46 ± 0.98, p = 0.17) or maximum procedural pain (median visual analog scale score aromatherapy: 65 [range: 4-95] vs placebo: 63 [range: 7-97], p = 0.91). Independent predictors of satisfaction included the use of oral sedation (B: 0.36; 95% CI: 0.04-0.69), state anxiety (B: -0.45; 95% CI: -0.79 to -0.10), and maximum procedural pain (B: -0.17; 95% CI: -0.25 to -0.09). The aromatherapy participants were significantly more likely to have found inhaling scented oil helpful during their procedure (71.9% vs 45.5%; p = 0.005) and would recommend it to a friend who needed a procedural abortion (86.0% vs 56.4%; p = 0.0005) compared to those in the placebo group. Additionally, patients in the aromatherapy group were significantly more likely to agree with the statement, "If I need another procedural abortion, I would want to inhale scented oil during my procedure" (87.7% vs 70.9%; p = 0.03).

CONCLUSIONS

The adjunctive use of lavender aromatherapy during first-trimester procedural abortion does not improve satisfaction with anesthesia but is highly valued by patients.

IMPLICATIONS

Oral opioids as an adjunct to standard analgesics during procedural abortion (ibuprofen and paracervical block) do not decrease pain, and nonopioid options are lacking. Given current limited anesthesia options, aromatherapy could serve as an affordable and acceptable nonopioid adjunct to current standard of care during procedural abortion.

CLINICALTRIALS

GOV IDENTIFIER

NCT04969900.

The effectiveness of aromatherapy in the management of labor pain: A meta-analysis

One non-pharmacological method that can be used to safely and without negative side effects is aromatherapy. This meta-analysis study was carried out to assess the effectiveness of aromatherapy in the treatment of labor pain. The analysis included 14 randomized controlled trials of aromatherapy interventions for labor pain. In the studies, it was observed that aromatherapy was applied through massage and inhalation using oils such as lavender, jasmine, rose, chamomile, bitter orange, and boswellia. In the meta-analysis, it was discovered that aromatherapy had a beneficial effect on the management of labor pain and reduced labor pain in the intervention group in 11 studies; it was found that there was no effect in 3 studies. According to analysis findings, aromatherapy significantly lessened the intensity of labor pain. The study's findings support the notion that aromatherapy can lessen labor pain.

Non-Pharmacological Pain Management in Labor: A Systematic Review

Childbirth is a remarkable, life-changing process and is frequently regarded as an excruciating, physically and emotionally demanding experience that women endure. Labor pain management poses a significant challenge for obstetricians and expectant mothers. Although pharmacological pain management is the gold standard, it still imposes risks on the mother and baby. Recently, non-pharmacological pain management (NPPM) has emerged as a safe, effective option. Six databases were searched for articles published up to 2023 using specific related keywords and defined inclusion and exclusion criteria. The extraction and gathering of data was made so as to be categorized into physical, psychological, and complementary NPPM techniques. In light of the enormous development and diversity of NPPM techniques, the present review aims to examine contemporary NPPM knowledge and application, discussing efficacy, advantages, limitations, and potential adverse effects, with a specific focus on women's individual requirements, to strengthen obstetricians' knowledge in guiding decision-making for women in childbirth.

Assessing Continuous Epidural Infusion and Programmed Intermittent Epidural Bolus for Their Effectiveness in Providing Labor Analgesia: A Mono-Centric Retrospective Comparative Study

Background and Objectives: Local anesthetics administered via epidural catheters have evolved from intermittent top-ups to simultaneous administration of continuous epidural infusion (CEI) and patient-controlled epidural analgesia (PCEA) using the same device. The latest programmed intermittent epidural bolus (PIEB) model is believed to create a wider and more even distribution of analgesia inside the epidural space. The switch from CEI + PCEA to PIEB + PCEA in our department began in 2018; however, we received conflicting feedback regarding workload from the quality assurance team. This study aimed to investigate the benefits and drawbacks of this conversion, including the differences in acute pain service (APS) staff workload, maternal satisfaction, side effects, and complications before and after the changeover. Materials and Methods: Items from the APS records included total delivery time, average local anesthetic dosage, and the formerly mentioned items. The incidence of side effects, the association between the duration of delivery and total dosage, and hourly medication usage in the time subgroups of the CEI and PIEB groups were compared. The staff workload incurred from rescue bolus injection, catheter adjustment, and dosage adjustment was also analyzed. Results: The final analysis included 214 and 272 cases of CEI + PCEA and PIEB + PCEA for labor analgesia, respectively. The total amount of medication and average hourly dosage were significantly lower in the PIEB + PCEA group. The incidences of dosage change, manual bolus, extra visits per patient, and lidocaine use for rescue bolus were greater in the PIEB + PCEA group, indicating an increased staff workload. However, the two groups did not differ in CS rates, labor time, maternal satisfaction, and side effects. Conclusions: This study revealed that while PIEB + PCEA maintained the advantage of decreasing total drug doses, it inadvertently increased the staff burden. Increased workload might be a consideration in clinical settings when choosing between different methods of PCEA.

Non-invasive sensory neuromodulation in epilepsy: Updates and future perspectives

Epilepsy, one of the most common neurological disorders, often is not well controlled by current pharmacological and surgical treatments. Sensory neuromodulation, including multi-sensory stimulation, auditory stimulation, olfactory stimulation, is a kind of novel noninvasive mind-body intervention and receives continued attention as complementary safe treatment of epilepsy. In this review, we summarize the recent advances of sensory neuromodulation, including enriched environment therapy, music therapy, olfactory therapy, other mind-body interventions, for the treatment of epilepsy based on the evidence from both clinical and preclinical studies. We also discuss their possible anti-epileptic mechanisms on neural circuit level and propose perspectives on possible research directions for future studies.

Effect of Midwife-Provided Orientation of Birth Companions on Maternal Anxiety and Coping during Labor: A Stepped Wedge Cluster Randomized Control Trial in Eastern Uganda

The study aimed to assess the effect of midwife-provided orientation of birth companions on maternal anxiety and coping during labor. A stepped wedge cluster randomized trial design was conducted among 475 participants (control n = 240), intervention n = 235) from four clusters. Midwives in the intervention period provided an orientation session for the birth companions on supportive labor techniques. Coping was assessed throughout labor and anxiety scores were measured after birth. Independent t-test and Chi-Square tests were used to assess the differences by study period. Anxiety scores were reduced among women in the intervention period (p = 0.001). The proportion of women able to cope during early active labor was higher during the intervention period (p = 0.031). Women in the intervention period had 80% higher odds of coping (p = 0.032) compared to those in the control period. Notable differences in anxiety and coping with labor were observed among first-time mothers, younger women, and when siblings provided support. Midwife-provided orientation of birth companions on labor support lowers maternal anxiety and improves coping during labor. Findings could inform the planning and development of policies for the implementation of the presence of birth companions in similar low-resource settings.

THE EFFECT OF LAVENDER AROMATHERAPY ON THE LEVEL OF INTRAOPERATIVE ANXIETY IN CAESAREAN CASE UNDER SPINAL ANESTHESIA: A RANDOMIZED CONTROLLED TRIAL

BACKGROUND

Preoperative anxiety can be reduced by aromatherapy. This study aimed to evaluate the effect of lavender aromatherapy in reducing intraoperative anxiety in patients undergoing caesarean section (CS) under spinal anesthesia.

METHODS

This study was two-armed and randomized controlled trial. A total of 96 patients who were scheduled for CS were randomly divided into two groups: the aromatherapy (A) group (n=48), comprising patients who were randomized to receive lavender aromatherapy with mask oxygen after the birth of the baby, and the control (C) group (n=48), comprising patients who inhaled carrier oil. During the preoperative period, baseline anxiety levels and Visual Analog Scale (VAS) pain scores were recorded using the State-Trait Anxiety Inventory (STAI-I) scale. After birth, two drops of oil were inhaled in an oxygen mask for 5 min. After 5 min, the Ramsey Sedation Scale was evaluated, and patients with a score of 1 received 2 mg of intravenous midazolam for sedation. The STAI-I and VAS pain scores were re-evaluated at the third postoperative hour.

RESULTS

The primary outcome was the significant reduction in the need for midazolam brought about by lavender aromatherapy, and the secondary outcomes included postoperative third-hour STAI-I scores, intraoperative complications and patient satisfaction.

CONCLUSION

The effectiveness of lavender aromatherapy, which reduced the need for intraoperative anxiolytics, can be offered as an alternative for pregnant women who undergo CS under spinal anesthesia.

Effectiveness of aromatherapy in reducing duration of labour: a systematic review

Childbirth is one of the most important events in woman's life. Different methods are typically used for labour augmentation. Aromatherapy is one of the complementary methods. The present systematic review evaluated the efficacy of aromatherapy in reducing the duration of labour. A systematic search of all clinical trials studies on Cochrane, Scopus, Web of Science, PubMed, ProQuest, Google scholar, Irandoc, Science direct, Magiran and Sid was performed up to September 2021. A total of 22 articles met the inclusion criteria and 3234 women used a variety of aromatherapies. Results showed that some aromatherapies, such as lavender was almost effective in reducing length of labour. Results suggest that some aromatherapy can be an effective, inexpensive and holistic method of reducing the duration of labour but it should be used with caution.

Analysis of the Use of Herbal Therapy to Reduce Labor Pain (Literature Review)

Abstract Background:.   labor pain can stress the mother and cause pain impulses to multiply and potentially weaken uterine muscle contractions. Pain can cause distress to the baby. One way to reduce pain is by giving herbal therapy or aromatherapy. Aromatherapy is one of the non-pharmacological methods to reduce labor pain. Aromatherapy often used to reduce labor pain is Lavender, Rose, Jasmine, Citrus Aurantium.   AIM: This study aims to determine the use of herbal therapy to reduce labor pain.The purpose of this study is to analyze the challenges in implementing health education in elementary schools in Banda Aceh   Methods: the design in this study was a literature review article. Search for articles using relevant ones obtained from data based on Pubmed, Proquest, Ebsco, ScienceDirect, and Google Scholar in the past ten years (2011–2021) received 121 articles. Results: The study results show several challenges in implementing health education. Lack of understanding about School Health Services, School Health Services is not considered a strategic program, Low attention from policymakers, School Health Services Program has not been understood as part of the national target, Implementation of UKS program in schools is only a formality, Implementation and development School Health Services program is not evenly distributed. Barriers to the Implementation of School Health Services in  Elementary School are the lack of optimal inter-sectoral cooperation, lack of trained personnel, high workload, and the impact of conflicting health issues, causing various School Health Services activities to be hampered in their Implementation   CONCLUSION: Utilization of herbal therapies such as Lavender, Mawar, Jasmine, Citrus, Aurantium has been proven to reduce labor pain which can be used in various methods such as inhalation, bath, massage, and foot soak. The easy use of aromatherapy can be an alternative to reduce labor pain.

O uso de óleos essenciais e aromaterapia no trabalho de parto

Introdução: a aromaterapia consiste na utilização de óleos essenciais na prevenção ou no tratamento de diversas afecções humanas. No trabalho de parto, pode ser aplicada para o alívio da dor e ansiedade. Objetivo: identificar na literatura científica sobre o uso da aromaterapia e dos óleos essenciais no manejo do trabalho de parto; e elaborar um protocolo hospitalar, a partir dos achados nas publicações, sobre aromaterapia e aplicação de óleos essenciais no trabalho de parto. Materiais e métodos: trata-se de revisão integrativa da literatura desenvolvida nas bases de dados LILACS, Cochrane Library e Pubmed. Incluíram-se artigos científicos originais publicados no período de 2000 a 2019. O material coletado foi analisado com base na análise temática de conteúdo de Laurence Bardin. Resultados: treze artigos integraram o corpus desta pesquisa. Deles emergiram quatro categorias de análise: 1- Aromaterapia como estratégia para o alívio da dor na fase de dilatação do trabalho de parto; 2- Aromaterapia como estratégia para a redução de ansiedade no trabalho de parto; 3- Métodos de administração dos óleos essenciais no trabalho de parto; e 4- O uso de óleos essenciais para o manejo de sintomas desagradáveis e da progressão do trabalho de parto. Discussão: a partir dos resultados, elaborou-se um protocolo hospitalar sobre o uso de aromaterapia no trabalho de parto. Conclusão: a aromaterapia é uma ferramenta adequada para o cuidado humanizado no manejo da dor e da ansiedade no trabalho de parto, sem efeitos adversos documentados na literatura levantada.

The Effectiveness of Neroli Essential Oil in Relieving Anxiety and Perceived Pain in Women during Labor: A Randomized Controlled Trial

Childbirth is a stressful and physically painful event in a woman’s life and aromatherapy is one of the most used non-pharmacological methods that is effective in reducing anxiety and perceived pain. This randomized controlled study aimed at determining the effect of neroli oil aromatherapy on anxiety and pain intensity perception in 88 women during labor, randomly assigned to either an intervention group (n = 44) or control group (n = 44). Anxiety and perceived pain were assessed through the visual analogue scale during the latent, early, and late active phases of labor. Data analyses included the t-test, Chi-square test, and repeated measures ANOVA. Perceived pain and anxiety in the group receiving aromatherapy were significantly lower than in the control group at all stages of labor (p < 0.05). Specifically, as the labor progressed, pain and anxiety increased in all participants, but the increase was milder in the experimental group than in the control group. The multiparas showed higher average anxiety scores, but not perceived pain, than the primiparas in all phases of labor (p < 0.05). Ultimately, neroli oil aromatherapy during labor can be used as an alternative tool to relieve anxiety and perceived pain in women during all stages of labor.

Effects of non-pharmacological coping strategies for reducing labor pain: A systematic review and network meta-analysis

BACKGROUND

Facilitating the childbirth process is a global issue. Many strategies have been developed to cope with labor pain and improve the delivery experience and satisfaction of pregnant women. The results of different types of medical intervention on women's expectant pain have been varied. Therefore, this systematic review was aimed at summarizing the body of evidence regarding the effects of various non-pharmacological coping strategies for reducing labor pain.

METHODS

The review was conducted according to guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We systematically searched the articles published between 1989 and 2020 in six electronic databases: PubMed, MEDLINE, CINAHL, WOS, PsycARTICLES, and Airiti Library, and the reference lists of the Clinical Trial Registry. Twenty studies were identified, with eight eligible studies included in the Bayesian network meta-analysis.

RESULTS

Eight studies with 713 participants were included in the meta-analysis with nine different non-pharmacological strategies for reducing labor pain. The traditional meta-analysis demonstrated that the non-pharmacological coping strategies were effective in reducing labor pain. Of these interventional strategies, the ranking probabilities analysis of the network meta-analysis suggested that the Bonapace Method may be the most effective strategy in reducing labor pain, followed by acupressure.

CONCLUSIONS

Non-pharmacological coping strategies can reduce labor pain while maintaining an effective and satisfactory delivery experience. This systematic review, by synthesizing the body of evidence, demonstrated that non-pharmacological coping strategies are effective in reducing labor pain. Furthermore, as demonstrated in the network meta-analysis, the Bonapace Method, modulating birth pain by involving the father, is the most effective non-pharmacological intervention for reducing labor pain.

Analgesic Potential of Terpenes Derived from Cannabis sativa

Pain prevalence among adults in the United States has increased 25% over the past two decades, resulting in high health-care costs and impacts to patient quality of life. In the last 30 years, our understanding of pain circuits and (intra)cellular mechanisms has grown exponentially, but this understanding has not yet resulted in improved therapies. Options for pain management are limited. Many analgesics have poor efficacy and are accompanied by severe side effects such as addiction, resulting in a devastating opioid abuse and overdose epidemic. These problems have encouraged scientists to identify novel molecular targets and develop alternative pain therapeutics. Increasing preclinical and clinical evidence suggests that cannabis has several beneficial pharmacological activities, including pain relief. Cannabis sativa contains more than 500 chemical compounds, with two principle phytocannabinoids, Δ9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD). Beyond phytocannabinoids, more than 150 terpenes have been identified in different cannabis chemovars. Although the predominant cannabinoids, Δ9-THC and CBD, are thought to be the primary medicinal compounds, terpenes including the monoterpenes β-myrcene, α-pinene, limonene, and linalool, as well as the sesquiterpenes β-caryophyllene and α-humulene may contribute to many pharmacological properties of cannabis, including anti-inflammatory and antinociceptive effects. The aim of this review is to summarize our current knowledge about terpene compounds in cannabis and to analyze the available scientific evidence for a role of cannabis-derived terpenes in modern pain management. SIGNIFICANCE STATEMENT: Decades of research have improved our knowledge of cannabis polypharmacy and contributing phytochemicals, including terpenes. Reform of the legal status for cannabis possession and increased availability (medicinal and recreational) have resulted in cannabis use to combat the increasing prevalence of pain and may help to address the opioid crisis. Better understanding of the pharmacological effects of cannabis and its active components, including terpenes, may assist in identifying new therapeutic approaches and optimizing the use of cannabis and/or terpenes as analgesic agents.

Aromatherapy in Obstetrics: A Critical Review of the Literature

Aromatherapy is the use of highly concentrated aromatic plant oils administered in various ways for a wide range of therapeutic indications. The purpose of this review is to present an overview of the evidence on aromatherapy during the perinatal period. There is research on the prenatal use of aromatherapy to treat nausea and vomiting, reduce stress, and support immune function; the intrapartum use of aromatherapy for labor pain/anxiety and labor progress; and the postpartum use of aromatherapy for postcesarean symptoms, perineal trauma, sleep, and symptoms of depression and anxiety. Overall, the evidence suggests that aromatherapy can be administered safely and effectively in obstetrics.

Labor Pain in Different Dilatations of the Cervix and Apgar Scores Affected by Aromatherapy: A Systematic Review and Meta-analysis

Labor pain (LP), as a physiological process, is known as one of the most severe pains. Aromatherapy is one of the methods to reduce LP in the first phase of labor. It is an important approach for enjoyable birth and decreases the severity of pain in today's society. Accordingly, this study aimed to systematically review the relieving effect of aromatherapy in LP and Apgar score. We used international databases such as EMBASE, Web of Science, Scopus, Google Scholar, PubMed, Cochrane Library, ProQuest, and clinicaltrials.gov to conduct a systematic search for all relevant articles. Cochran's Q-test and I² statistic were applied to assess heterogeneity, a random-effects model was used to estimate the unstandardized mean difference (UMD), and a meta-regression method was utilized to investigate the factors affecting heterogeneity between studies. A total of 27 studies were included in the meta-analysis (sample size: 2,566). Overall, aromatherapy leads to relieving LP during delivery (UMD: 1.75; 95% CI: 1.13-2.37). Based on cervix dilation, aromatherapy significantly affects LP when cervix dilation is 8-10 cm (UMD: 6.18; 95% CI: 4.51-7.85) and 0-4 cm (UMD: 5.31; 95% CI: 3.74-6.87); but it had no effects on 1- and 5-min Apgar scores. No publication bias was observed (P=0.113). Mother's age, publication year, sample size, and cervix dilation had no significant effects on heterogeneity (P>0.05). Aromatherapy had a positive impact on relieving LP, and the greatest and least effect was witnessed in dilatation of 8-10 cm and 0-4 cm, respectively. Moreover, it had no effects on 1- and 5-min Apgar scores.

Efficacy and safety of non-pharmacological interventions for labour pain management: A systematic review and Bayesian network meta-analysis

AIMS AND OBJECTIVES

To compare and rank the efficacy and safety of non-pharmacological interventions in the management of labour pain.

BACKGROUND

Recently, various non-pharmacological interventions have been applied to manage labour pain and have shown positive effects. However, evidence identifying which type of non-pharmacological intervention is more efficient and safer is limited.

DESIGN

Systematic review and Bayesian network meta-analysis based on PRISMA-NMA.

METHODS

Seven databases were searched from database inception-March 2020. Two reviewers independently performed study selection, quality appraisal and data extraction. Conventional meta-analysis was conducted using either fixed-effects model or random-effects model according to statistical heterogeneity. The Bayesian network meta-analysis was conducted using the consistency model.

RESULTS

43 studies involving nine non-pharmacological interventions were included. The Bayesian network meta-analysis showed that acupressure (SMD = -2.00, 95% CrI -3.09 to -0.94), aromatherapy (SMD = -2.01, 95% CrI -3.70 to -0.35) and massage therapy (SMD = -1.26, 95% CrI -2.26 to -0.30) had significant positive effects on alleviating labour pain, with aromatherapy being the most effective. The results also revealed that yoga (SMD = -130.85, 95% CrI -212.01 to -59.32) and acupressure (SMD = -10.14, 95% CrI -20.24 to -0.41) were the most effective interventions for shortening the first stage and the second stage of labour, respectively. There were no significant differences between non-pharmacological interventions and usual care or placebo control on the use of pharmacological methods and neonatal 5-min Apgar score.

CONCLUSIONS

The evidence in this network meta-analysis illustrates that non-pharmacological interventions are effective and safe for labour pain management in low-risk pregnant women. In the future, well-designed studies are needed to validate the conclusion of this network meta-analysis.

RELEVANCE TO CLINICAL PRACTICE

The results support the use of non-pharmacological interventions, especially aromatherapy and acupressure, to relieve labour pain in low-risk pregnant women. Non-pharmacological interventions for labour pain management are recommended to apply according to maternal women's preference and values.

Peripartum management for women with opioid dependence

PURPOSE OF REVIEW

Opioid use disorder (OUD) in pregnancy has more than quadrupled in prevalence over the past two decades and continues to increase steadily every year. With no defined standard of care for the management of pain during the peripartum period, variability in treatment plans potentially leaves room for interrupted patient care, decreased patient satisfaction, and poorer outcomes. The impact of OUD and its management during the peripartum period has become more widely discussed over the past several years and is the focus of this review.

RECENT FINDINGS

Current recommendations including developing a detailed institutional plan for the management of pain for women with OUD during the intrapartum and postpartum periods. There is tremendous value in exploring partnerships with other specialties, including addiction medicine, and behavioral health and obstetrics in development of policies and procedures. Consistency within institutions is critical to improve patient outcomes.

SUMMARY

This review will address both pain management recommendations and best clinical practices regarding management of the parturient during the transition periods of the peripartum, intrapartum, and postpartum period. Novel approaches and perspectives from case reports and narrative experience will also be discussed. There are many opportunities in this field for further studies, research, and evidence-based guidelines that promote an established standard of care.