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2 1 (TENS) Kocagil Yurtkuran TENS Ownby Large intestine 4 LI4 1 - Transcutaneous Electrical Nerve Stimulation

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5 LI4 Melzack LI4 LI4 waters post pre-test pre-test TENS A C test Grant Chao TENS

6 References 1. Abushaikha L, Oweis A. Labour pain experience and intensity: a Jordanian perspective. Int J Nurs ract. 2005; 11(1): Brownridge. The nature and consequences of childbirth pain. Eur J Obstet Gynecol Reprod Biol. 1995; 59: Mccrea H. Satisfaction in childbirth and perceptions of personal control in pain relief during labor.journal advanced nursing. 1999; 29(4): Simkin, Bolding A.Update on nonpharmacologic approaches to relieve labor pain and prevent suffering. Journal of midwifery & women's Healh.2004; 49(6): Melzack R, Stillwell DM, Fox E. Trigger points and acupuncture points for pain:correlation and implications. ain. 1977; 3(1): Melzack R, Jeans ME, Stratford JG, et al. Ice massage and transcutaneous electrical stimulation: Comparison of treatment for low back pain. ain. 1980;9(2): Yurtkuran M, Kocagil T. TENS, electroacupuncture and ice massage: comparison of treatment for osteoarthritis of the knee. Am J Acupunct. 1999;27(3-4): Ownby KK. Effects of ice massage on neuropathic pain in persons with AIDS. J Assoc Nurses AIDS Care. 2006;17(5): Grant AE. Massage with ice in thetreatment of painful conditions of musculoskeletal system.arch phys med. 1964; Bodian CA, Freedman G, Hossain S. The visua lanalog scale for pain: clinical significance in postoperative patients. Anesthesiology. 2001;95(6): Waters BL, Raisler J. Ice massage for the reduction of labor pain. Journal of midwifery & women's Health. 2003;48(5): Shedletsky, Gale EN, Levine MS. The effects of ice massage applied over the "Hoku" acupuncture point in reducing spontaneous pain of endodontic origin. J Can Dent Assoc. 1984;50(8):635-8.

7 13. Chao AS, Chao A, Wang TH, et al. ain relief by applying transcutaneous electrical nerve stimulation (TENS) on acupuncture points during the first stage of labor: a randomized double-blind placebo-controlled trial. ain. 2007;127(3): ooria Mofrad E, Lotfizadeh M, Keyani M. [Effects of transcutaneous electrical nerve stimulation (TENS) on labor pain]: ersian. Journal of Shahrekord University of Medical Sciences. 2002; 4(3): Lowdermilk DL, erry SH.Maternity Nursing. 6th ed Ed. New York: Mosby. 2003: Waters Bette L. Massage during pregnancy.bluwaters ress. 2000: Mccafery M, Beebe A. ain: Clinical manual for nursing practice. St Louis: Mosby. 1989; Kimberly K, Trout. The neuromatrix theory of pain: Implications for selected nonpharmacologic methods of pain relief for labor.journal of Midwifery & Women's Health. 2004;49(16): Kaada B, Torsteinb O.Increase of plasma beta-endorphins in connective tissue massage. Gen harmacol. 1989;20(4):487-9.

8 Relieving Labor ain by Ice Massage of the Hand Safdari Dehcheshmeh Faranak, MSc*; Delaram Maesoomeh, MSc*; Salehian Tahmineh, MSc**; Moradi Mohammadtaghi, MSc***; Rahimi Madiseh Mohammad, MSc****; Aliakbari Fatemeh, MSc****; Received: 29/Jul /2008 Accepted: 14/Mar /2009 Background: Labor pain is the worst pain experience during women's life. The management of labor pain is amongst the leading goals of maternity care. Unrelieved labor pain may adversely affect both mother and the neonate. The aim of this study was to determine the effect of Hoku point ice massage on pain intensity in primiparous women during labor. Materials and Methods: A randomized controlled trial was conducted on 60 primiparous women who were expected to have normal childbirth in Hajar Hospital of Shahrekord. All participants were randomly assigned in two groups (n = 30): ice massage (treatment) and sand bag group (control). The severity of the basal pain was measured at the beginning of active phase (4 cm cervical dilation) based on Visual Analogue Scale (VAS). Then, after two groups received intervention, the severity of the labor pain in 4, 6, 8 and 10 cm cervical dilation was measured. In the case group, the crushed ice twisted in a terry bag was rocked on the web of skin between thumb and forefinger. The massage was carried out in Hoku point throughout three contractions. The sand bag tactile massage in Hoku point was served in the control group. The data were analyzed using SSS software and descriptive analysis using Mann- Whitney, x2, paired and independent t tests and <0.05 was considered significant. Results: After completion of intervention, the pain intensity in the treatment group was significantly less than the control group <0.001). Also, mean duration of active phase of labor in treatment group was significantly less than the control group (<0.05). In the treatment group, the difference between the mean of the pain pre and post intervention was significant just in 4, 6 and 8 cervical dilation (<0.001). Conclusions: Regarding the ice massage as a cost-effective and noninvasive nursing intervention and considering high satisfaction of patients, we recommend this safe and easy-to-use technique for alleviation of the labor pain. KEY WORDS: ain relief, labor pain, ice massage, Hoku point *Instructor, Dept of Midwifery, Faculty of Nursing & Midwifery, Shahrekord University of Medical Sciences and Health Services, Shahrekord, Iran. **Instructor, Dept of Midwifery, Faculty of Nursing & Midwifery, Zahedan University of Medical Sciences and Health Services, Zahedan, Iran. ***Instructor, Cellular&Molecular Research Center, Shahrekord University of Medical Sciences and Health Services, Shahrekord, Iran. ****Instructor, Dept of Nursing, Faculty of Nursing & Midwifery, Shahrekord University of Medical Sciences and Health Services, Shahrekord, Iran.

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