A STUDY TO ASSESS THE EFFECT OF FOOT REFLEXOLOGY ON

PAIN AND DISCOMFORT OF MOTHERS

AFTER CAESAREAN SECTION

IN A SELECTED HOSPITALS

BANGALORE

W
By
IE
SUNILA THOTTINGAL

Dissertation Submitted to the

EV

Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore

In partial fulfillment
PR

of the requirement for the degree of

Master of Science

in

Obstetrics and Gynaecological Nursing

Under the guidance of

Mrs. Maria Preethi Miranda, [Link]. (N)
Department of Obstetrics and Gynaecological Nursing
Krupanidhi College of Nursing
Bangalore

2013
 1. INTRODUCTION

“A woman giving birth to a child has pain because her time has come; but when

her baby is born she forgets the anguish because of her joy that a child is born into

the world .’’

John 16: 21

Child birth is one of the most marvellous and memorable segments in woman‟s life. It

W
is a natural physiological event.1This period is filled with many intense and diverse

feelings, encompassing excitement, expectancy, anxiety and even fear. The child birth
IE
is universally celebrated as an event and a happy occasion of rejoicing. It is one of the
EV

happiest moments and a challenging event in a woman‟s life.2 The time of labour and

birth, though short, in comparison with the length of pregnancy, it is the most dramatic

and significant period of life for an expectant woman.

PR

The birth of a child should be one of life‟s crowning experiences, the culmination of

nine months waiting and the beginning of parenthood. But nature does not always get

it right and not all births can be normal deliveries through the mother‟s vagina (birth

passage). Medical assistance with birth is then necessary to rescue the baby or mother

from impending disaster.3 Caesarean section is an operation to deliver the baby

through the mother‟s abdomen and is considered as one of the oldest type of surgical

procedure.4

1
At global level the rate of caesarean section is on the rise. Between five and ten

percent of babies are born by caesarean section, there has been a tremendous increase

in the rate of caesarean delivery for the past three decades. Worldwide, the rate has

been nearly one in two births in China, two in five births in Thailand and Vietnam,

nearly one in five in India. According to World Health Organization, which reviewed

110,000 births from nine countries in Asia (2010), 27 percent births were delivered by

caesarean section.5

India is also experiencing a rapid increase in caesarean section deliveries along with

W
an increase in institutional deliveries. Caesarean section rates increased from 25.4% to

32% and about 32% has been documented from South India. In Karnataka about
IE
22.2% of caesarean births are noted. The caesarean section rate of above 15

percentage has not been acceptable, whereas in India the prevalence rate has been 18
EV

percentage. Clearly these rates are unacceptably high all over the globe.4
PR

The reason for this increase in caesarean section is due to the complications such as

breech baby or a vaginal birth that is not progressing may call for a caesarean section,

partially motivated by hospitals eager to make more money. Shockingly, more than

60% of the hospitals studied, shows that the caesarean sections were done for financial

gains and not because it was required. Caesarean section is seldom a matter of choice

for an expecting mother. Experts say this boom in unnecessary caesarean section

surgeries is jeopardizing women's health. Fear of labour makes these women opt for a

caesarean section.4

2
Following caesarean section, mother may experience pain and a number of effects

including confusion, trembling and drowsiness. For a period of several days, mother

may also experience constipation, which causes discomfort in the stomach and

abdominal area. This can lead to pain in the abdominal area as well as nausea. These

symptoms are seen more likely if mother have been put under general anaesthesia for

an emergency caesarean section.6

Pain is an expected postoperative outcome. All patients who have just had surgery will

experience pain.7 Pain is not an unavoidable consequence of surgery.8 Pain medication

W
should be given when needed prior to the severity of pain, yet one of the most frequent

post operative problems is inadequate analgesic administration.7 In majority of

IE
patients, post operative pain is preventive with adequate analgesics and by the

appropriate use of newer techniques.

EV

Effective pain control is best achieved through a combination of pharmaceutical and

PR

non- pharmaceutical therapies. Pharmaceutical management has been the primary

means of providing relief from pain.5 Post operative pain is poorly controlled by

pharmacological means alone. Complementary strategies based on sound research

findings are needed to aid in post operative pain relief as patients routinely report mild

to moderate pain even though pain medications have been administered.9

Although pharmaceutical medications continue to serve as a major contributor to pain

management, but non-pharmaceutical techniques are also being increasingly used to

provide pain relief. Non- pharmaceutical interventions are particularly useful when

3
a) medications are inadequate to control pain; b) client is waiting for medication to

take effect; c) when side effects or client concerns make the use of medications

problematic and have fewer side effects compared to pharmaceutical interventions.7

Despite the technological advancement in health care, routine analgesic procedures in

post operative pain control remain inadequate and thus require complementary

therapies and interventions. In recent years, many complementary therapies such as

massage, soothing music, relaxation, mind–body techniques, herbal medicines,

hypnosis, therapeutic touch and reflexology are tried to help manage pain.10 However,

W
it is evident that sound evidences from a wide range of studies will be needed to show

their efficiency so as to enhance the applicability of these therapies.

IE
Use of Reflexology has been there around for over 4000 years, originally practised by
EV

the ancient Egyptians and Chinese but it was first recognised in the Western World in

1913 when Dr William Fitzgerald noticed that pressure on specific parts of the body
PR

could have an anaesthetising effect on corresponding areas in the body. This was

further developed in 1930s by Eunice Ingham, who defined reflexology as it is

practised today. It is an ancient, mild and non-invasive technique, used widely as one

of the non-pharmacological methods for pain relief.11

Reflexology works on the principle that there are energy zones that run throughout the

body and reflex areas in the feet that correspond to all the major organs, glands and

body parts.12 It is based on a system of zones and reflex areas on the feet and palms

that reflect an image of the entire body (including muscle, nerve, gland and bone) in

4
exactly the same order and position as in the body. It is thought that the hands and feet

are like mirror images of the body, with various points representing different

structures and organs.11

Reflexology is based on the ancient massage technique that applies pressure on parts

of the feet, or sometimes the hands and ears, to clear the vital energy pathways that

can become blocked due to the stresses and strains of life.10 Practitioners of foot

reflexology believe that foot is connected to all major organs and glands in the body.

In the feet there are reflex areas, which relate to all organs and systems within the

W
body and these reflex areas are found on the soles, tops and sides of the feet. The feet

as a whole correspond to the whole body. By working the feet, it is possible to find out
IE
which areas of the body are out of balance and treatment can be given to rebalance the

body by stimulating its own healing mechanism.11

EV

It is one of the most miraculous means of utilizing nature's own healing method for
PR

maintaining the body among the people under postoperative condition and with

problems that are least familiar to us. It does not require any pills, drugs and

tranquilizers.14 Reflexology is very comforting for a mother recovering from a

caesarean section. Sessions during the first week after a caesarean is aimed at helping

in pain management, improving bowel functions, as well as reducing swelling and

fluid retention. In several cases, working with maternity clients within hours of

surgery has provided comfort during symptoms of shaking and chills as the epidural

wears off.13

5
Due to this pain relieving effect of foot reflexology, this can be used in post caesarean

mothers. There by it will result in rapid relief from pain and discomfort after the

caesarean section.

Need for the study

„„Pain is an elusive and complex phenomenon and despite its universality its exact

nature remains a mystery‟‟.7

W
Child birth is one of the greatest events in every woman‟s life. It is the fulfilment of

their dreams.15 Though it is the happiest event in every woman‟s life, the process of
IE
child birth is a painful event. Pain is a complex, multifaceted phenomenon. Pain

varies among individual, with a unique experience that may be difficult to describe
EV

or explain and often difficult for others to recognize, understand and assess.7 Acute

and unrelieved pain can cause physical and mental complications, delayed recovery
PR

and prolonged hospitalization.16

As like any surgery, the mother usually will have some degree of pain and

discomfort after a caesarean section. Right after, the caesarean section the mother

may feel itchy around the incision, sick to her stomach, and sore, these are all normal

reactions to the anesthesia and surgery. If general anesthesia is needed for an

emergency caesarean section, mother may feel confused, chilly, scared, alarmed, or

even sad. Some may also experience a number of effects including confusion,

trembling and drowsiness. Stomach discomfort is also a common effect after a

6
caesarean section. This can include pain in the abdominal area as well as

constipation.17 For the first few days and even weeks, patient may feel, tired have

soreness around the incision, constipated and gassy, have a hard time getting around

and/or lifting the baby.18

Over the years, mankind had devised many methods to combat pain. Pain relief

methods can be divided into two main groups: pharmacological and non-

pharmacological ones.19 Post operative pain is routinely poorly controlled by

pharmacological means alone. Complementary strategies based on sound research

findings are needed to aid in post operative pain relief as patients routinely report

W
mild to moderate pain even though pain medications have been administered.9 One
IE
of the most significant limitations associated with pharmacological pain relief is that

almost every drug used as analgesics has got deleterious effects over mother.20
EV

Analgesics have a maximum effective dose, increasing the dose cannot decrease pain

relief, but may increase the side effects.7

PR

A randomized controlled trail was conducted in Osaka, Japan among healthy women

who underwent caesarean section under spinal anaesthesia to determine the extent of

postoperative analgesia and side-effects produced by low doses of intrathecal

morphine. Patients were randomly allocated to receive, in double-blind fashion, 0 mg

(group 1: control group), 0.05 mg (group 2), 0.1 mg (group 3), or 0.2 mg (group 4) of

morphine, with 10 mg tetracaine in 10% dextrose 2.5 ml. (n = 20 × 4 groups). The

effect of intra thecal morphine was examined in terms of the duration until the first

supplemental analgesic was needed and the numbers of the doses within the first

postoperative 48 hourly. Pain relief was significantly greater in groups 3 and 4 than in

7
group 1. The incidence of nausea, vomiting and pruritus increased in a dose-dependent

manner. The results suggest that postoperative analgesia lasts more than 24 hour with

0.1 mg or 0.2 mg of intrathecal morphine. Since the incidence of side-effects was

higher at 0.2 mg, 0.1 mg may be the optimum dose for caesarean section.21

A study was conducted in Kings George Medical College on effect of commonly

used non steroidal anti-inflammatory drugs (NSAIDS) on gastric mucosa. It was

found that all these drugs were known to produce gastro intestinal lesions. Here they

found that Aspirin, Endomethacin and Phenylbutazone caused gastric mucosal

W
damages in 33.3%, 37.5% and 15% of the population respectively.9 Although using

analgesia is usual to relieve pain, its complication, unavailability, necessity of taking

IE
low dose drug, and also ineffectiveness of using analgesia alone, to relieve pain has

focused today‟s nursing system on complementary treatments and non

EV

pharmacological interventions.22
PR

At the present scenario there are some alternative therapies to reduce post operative

pain without causing any adverse effects. Few scientific studies have been done in

this area, many women have reported benefits from acupressure, acupuncture,

various herbal remedies, hot application, yoga and foot reflexology.9Among these

complimentary therapies foot reflexology has found to be effective and commonest

method used to relieve pain.

Reflexology is one of the most miraculous means of utilizing nature‟s own healing

method. It does not require any pills or drugs. In each foot there are more than 7200

nerve endings which have an extensive interconnection with the central nervous

8
system. These nerve endings are a part of our sensory apparatus in which they sense

pain and pressure. The feet are also important in perception, sensing or determining

the physical position of a person. Essentially reflexology stimulates or fine tunes

this sensory apparatus and its neural pathways.11 There are many theories of

reflexology; the important theory associated with pain is the gate control theory.

Reflexology is an act of applying pressure on the corresponding point of disordered

organ or area of body to the feet and hands using specific thumb, finger and hand

techniques. The physiological changes achieved with the application of pressure are

based on the neurological relationship that exists between the skin and the nervous

W
system, in such a manner that a therapeutic effect can be achieved by stimulation at a
IE
distance from the area where the pressure is applied. Reflexology believes the body

is mirrored on the feet and hands and works within a zonal system.12 Reflexology
EV

works as the pressure techniques applied to the feet or hands interact as a part of the

body's nervous system creating relaxation, improved circulation, and exercise of the
PR

nervous system and the benefits of touch. Stretch and movement techniques are

utilized as "desserts" to provide relaxation to the foot.23

A clinical trial study was conducted to investigate the effect of foot reflexology on

pain and physiological parameters after caesarean section at Alzhara Hospital (Rasht

City) Iran, and 62 women were included in the study. They were randomly divided

into two groups of case and control. The reflexology group received a 30 minute foot

massage in two sessions, with 24 hours interval. The researchers analysed the end

results with the help of step - visual analogue scale and pain score form. Findings of

the study concluded that in case group, severity of pain after first stage of foot

9
reflexology was significantly lower than before reflexology session and also in

control group respectively (p <0.001, p <0.001). The severity of pain after second

stage was significantly reduced in case group when compared with control group.

The researchers concluded that foot reflexology appears to be a useful method for

reducing postoperative pain.16

A clinical trial study was conducted by Jamileh Mokhtani and co. to compare the

impact of foot reflexology massage and Bensone relaxation on severity of pain after

caesarean section. Non- probability convenient method of sampling was used.

Samples were placed in two groups: Foot reflexology massage and Benson

W
relaxation and a control group. Pain was measured using a standard numerical pain
IE
scale. Comparison of the mean of pain severity was separately significant between

two groups and measured group (p<0.05). Difference between the mean of pain
EV

severity also was significant between foot reflexology massage and Benson

relaxation (p= 0.0001). The study results concluded that both the measures were
PR

effective in decreasing the severity of pain in post caesarean mothers and the effect

of foot reflexology was more than Benson relaxation.24

A randomized controlled experimental study was conducted in Eskisehir Public

Hospital, Gynaecology and Obstetrics Hospital, and Osmangazi University Education

and Training Hospital, Turkey. To assess the efficiency of foot and hand massage on

reducing postoperative pain in patients who had undergone caesarean section.75 study

patients out of 281 were selected by random sampling method and the patient‟s

presenting orders and evenly divided into three groups: a control group, a foot and

hand massage group, and a foot massage group, each of which included 25 patients.

10
In the light of the results, it was reported that the reduction in pain intensity was

significantly meaningful in both intervention groups when compared to the control

group.25

A quasi experimental study was conducted with the purpose of comparing effects of

symptom management with reflexology on pain in patients after abdominal surgery.

Samples of 40 post operative patients were assigned to experimental group and

control group equally. Data was analysed by using descriptive statistics and t- test.

The major findings shows the post- test mean score on pain of an experimental group

W
was significantly lower than of the pre test ( ᵡ2 = 7.230, ᵡ2= 3.75, t = 16.335,

p < .001). The post test mean score of pain of an experimental group was
IE
significantly lower than of a control group (ᵡ2 = 3.75, ᵡ2 = 6.65, t = -10.627, p < .001).

The study concludes that there is a positive correlation between the foot reflexology
EV

and postoperative pain.26

PR

The investigator as a midwife during her clinical experience period has come across

many women suffering from agonizing pain and discomfort during post caesarean

section. Investigator found that mothers who have undergone caesarean section

suffered from pain and discomfort while feeding the baby, nausea and vomiting due

to the adverse effects of analgesics, also pain while moving and walking. On

investigating the investigator found majority of women like to receive non-

pharmacological pain relief strategies and avoid pharmacological measures. The

depth of review and the information available about the new advancing alternative

therapies to manage pain made the investigator to double her interest towards the use

11
of foot reflexology to relieve pain among women who have undergone caesarean

section.

Statement of the problem

A study to assess the effect of foot reflexology on pain and discomfort of mothers

after caesarean section in selected hospitals, Bangalore.

This chapter has briefly dealt with the existing problem and need for undertaking this

W
particular research project.
IE
EV
PR

12
 2. OBJECTIVES

The purpose of objective is to identify the relationship among variables or to

determine differences between the groups of selected variables.29

Statement of the problem:

A study to assess the effect of foot reflexology on pain and discomfort of mothers

after caesarean section in selected hospitals, Bangalore.

W
IE
Objectives of the study:
EV

1. To determine the effectiveness of foot reflexology on pain and discomfort of

mothers after caesarean section in experimental group.

PR

2. To compare the pain and discomfort of mothers between experimental group and

control group.

3. To determine the association between selected demographic variables and pain of

mothers after caesarean section in experimental group and control group.

4. To determine the association between selected demographic variables and

discomfort of mothers after caesarean section in experimental group and control

group.

5. To find the opinion of mothers who have undergone caesarean section with regard

to the acceptance of foot reflexology.

13
Hypothesis:

H1: There is a significant difference between the pre test pain scores and post test pain

scores after foot reflexology in experimental group.

H2: There is a significant difference between the pre test discomfort scores and post

test discomfort scores after foot reflexology in experimental group.

H3: There is a significant difference between the pain scores in experimental group

and control group after foot reflexology.

H4: There is a significant difference between the discomfort scores in experimental

W
and control group after foot reflexology.
IE
H5: There is a significant association between selected demographic variables and

pain scores of mothers after caesarean section in experimental group.

EV

H6: There is a significant association between selected demographic variables and

pain scores of mothers after caesarean section in control group.

PR

H7: There is a significant association between selected demographic variables and

discomfort scores of mothers after caesarean section in experimental group.

H8: There is a significant association between selected demographic variables and

discomfort scores of mothers after caesarean section in control group.

14
Operational definitions:

Effectiveness:

Refers to the extent to which foot reflexology helps in reducing pain and discomforts

of mothers after caesarean section as evidenced by a difference in pain and

discomfort scores of mother in experimental and control group.

Foot Reflexology:

W
Foot Reflexology is the practice of applying pressure to the feet and hands utilizing
IE
specific thumb, finger and hand techniques without using oil, lotion or cream based

on a system of zones and reflex areas that reflect an image of the body on the feet
EV

and hands with a premise that such work effects a physical change in the body.11
PR

In this study it refers to providing foot massage and foot acupressure for each

extremity for 30 minutes, once a day for a duration of two days for mothers who have

undergone caesarean section.

Pain:

In this study it refers to the unpleasant sensory experience associated with surgical

incision on the abdomen and the uterus as measured by numerical pain scale.

15
Discomfort:

Refers to an experience of unpleasantness after the caesarean section, mainly due to

pain and symptoms such as nausea and vomiting, dizziness, fatigue caused by

analgesics as measured by discomfort rating scale.

Mothers:

Refers to the mothers in the first and second post operative day who have undergone

W
caesarean section and admitted in postnatal ward of selected hospitals.
IE
Caesarean section:
EV

Refers to the operative procedure whereby the foetuses after the end of 28 th week are

delivered through an incision on the abdominal and uterine walls.15

PR

Assumptions

1. The post caesarean pain is a subjective feeling and can be measured by numerical

pain scale.

2. The post caesarean pain may cause some discomfort in mother.

3. Foot reflexology is a useful method for reducing post operative pain.

16
Delimitations

The study is limited to the mothers who have undergone caesarean section from the

selected hospitals.

Projected outcome

The present study reveals the effect of foot reflexology on pain and discomfort of

mothers after caesarean section.

Conceptual framework
W
IE
EV

Conceptual framework is the interrelated concepts or abstractions that are assembled

to gather in some rational scheme by nature of their relevance to a common theme,

sometimes referred to conceptual scheme.29The present study is intended to determine

PR

and to find out the effect of foot reflexology on pain and discomfort of mothers who

have undergone caesarean section. The investigator found that Ernestine

Wiedenbach‟s (1969) prescriptive theory30is best suited to study the effect of foot

reflexology on pain and discomfort of mothers after caesarean section in selected

hospitals, Bangalore.

17
Wiedenbach‟s Prescriptive Theory

Wiedenbach‟s Prescriptive Theory has three concepts:

1. The central purpose, which the practitioner recognizes as essential to the

practice of the discipline.

2. The prescription for the fulfilment of the central purpose.

3. The realities of the immediate situation that influence the fulfilment of the

central purpose.

Central purpose

W
The nurse‟s central purpose defines the quality of health she describes to affect or
IE
sustain in her patients and specifies what she recognizes to be her special
EV

responsibility in caring for the patient. Once the nurse has identified that the patient

has autonomy and individuality. She can work with the individual to develop a

prescription or plan for his or her care. In the present study, the central purpose of the
PR

nurse is to reduce the pain and discomfort of the mothers.

Realities

Realities consists of all factors- physical, physiological, emotional and spiritual those

are at play in a situation in which nursing actions occur at any given moment.

Wiedenbach‟s defines the five realities are:

1. The agent

18
 2. The recipient

3. Goal

4. Means

5. Framework

The agent, who is a practicing nurse or her delegate, is characterised by personal

attributes, capacities and most importantly commitment and competence in nursing.

Here, in the present study, the agent is the investigator, who is characterised by

capacities, commitment, capabilities and experience.

W
The recipients, the patients are characterised by personal attributes, problems
IE
capacities aspirations and most importantly, the ability to cope with the concerns as

problems being experienced. In the present study, the mothers who have undergone
EV

caesarean section are the recipients, who are characterised by personal attributes such

as age, education, occupation, parity and history of previous caesarean section.

PR

The goal is the desired outcome the nurse wishes to achieve. In the present study, the

investigator‟s goal is to decrease pain and discomfort of mothers who have undergone

caesarean section.

The means comprises the activities and devices through which the practitioner is

enabled to attain his/her goal. In the present study the means comprises of identifying

the pain and discomfort of the mothers who have undergone caesarean section by

using the Numerical Pain Rating Scale and Discomfort Rating Scale.

19
The framework consists of the human, environmental, professional and organizational

facilities that not only make up the context within which nursing is practical but also

constitutes its currently existing limits. In the present study, the framework includes

the environment of the institution and existing rules and regulations.

Prescription

The nurse develops a prescription for care that is based on her central purpose which

is implemented in the realities of the situation. The prescription developed by the

W
investigator is the administration of foot reflexology. The foot reflexology is

administered to the mothers who have undergone caesarean section to achieve the
IE
central purpose of the investigator.
EV

The investigator, after extensive review of literature, discussion with experts and her

personal experience of being with the mothers who have undergone caesarean section
PR

make an assumption that foot reflexology helps in the reduction of pain and

discomfort and promotes ease. In order to reduce the pain and discomfort of the

mothers who have undergone caesarean section (central purpose), the intervention ie,

foot reflexology was introduced (prescription). Then the investigator validates the

effectiveness of foot reflexology on pain and discomfort of mothers who have

undergone caesarean section in selected hospitals.

20
 Agent:
Investigator Effective in reducing the pain &
Personal attributes discomfort
Capacities
Commitment
Competence
Experience

W
IE
Central purpose

Recipient Means
Framework Goals
Numerical Prescription
Postnatal

EV
Environment of Reduction of pain rating
mothers who the institution Use of foot
pain Scale
have undergone Rules & reflexology
&discomfort of Discomfort
C- section Regulations rating scale
mothers who
Pain responses
have undergone
PR
Discomfort Feed
C-section
measure to back
relieve the
discomfort of
In effective in reducing the
mothers
pain & discomfort

........ Not included in the study

Figure 1: Conceptual Framework based on Ernestine Wiedenbach‟s Prescription Theory

21
 3. REVIEW OF LITERATURE

The present study is undertaken to assess the effectiveness of foot reflexology on

pain among mothers who have undergone caesarean section. The investigator did an

extensive search of the existing literature and organised it under the following

headings.

W
1. Effect of foot reflexology on post caesarean pain.

2. Effect of foot reflexology on post operative pain.

IE
3. Effect of foot reflexology on medical condition.
EV

1. Effect of foot reflexology on post caesarean pain.

PR

A study was conducted to examine the effectiveness of acupressure for controlling

post-caesarean section symptoms, such as nausea and vomiting, anxiety perception

and pain perception at Chung Hwa College of Medical Technology, Taiwan. The

study was carried out on 104 patients who were recruited by convenience sampling of

operating schedules at two hospitals. Patients assigned to the experimental group

received acupressure, and those assigned to the control group received only

22
 postoperative nursing instruction. The experimental group received three acupressure

treatments. The first treatment was performed the night before caesarean section, the

second was performed 2-4 hours after caesarean section, and the third was performed

8-10 hours after caesarean section. The measures included the Rhodes Index of

Nausea and Vomiting, Visual Analogue Scale for Anxiety, State-Trait Anxiety

Inventory, and Visual Analogue Scale for Pain, and physiologic indices. Statistical

methods included percentages, mean value with standard deviation, t test and repeated

measure ANOVA. The use of acupressure reduced the incidence of nausea, vomiting

from 69.3% to 53.9%, compared with control group (95% confidence interval =1.65-

W
0.11; p = 0.040) 2-4 hours after caesarean section and from 36.2% to 15.4% compared

with control group (95% confidence interval = 0.59-0.02; p = 0.024) 8-10 hours after
IE
caesarean section. Results indicated that the experimental group had significantly

lower anxiety and pain perception of caesarean experiences than the control group.
EV

Significant differences were found in all physiologic indices between the two groups.

The researchers concluded that the utilization of acupressure treatment to promote the
PR

comfort of women during caesarean delivery is strongly recommended.31

A randomized, double-blind and controlled trial was conducted to determine the effect

of P-6 acupressure on prevention of nausea and vomiting after epidural morphine for

post-caesarean section pain relief. The study was conducted at Veterans General

Hospital, Taipei, Taiwan. Sixty parturients receiving epidural morphine for post-

caesarean section pain relief were investigated. Parturients were allocated to receive

the acupressure bands or placebo bands on the P-6 acupoint bilaterally before the

23

Reproduced with permission of copyright owner. Further reproduction prohibited without permission.