Analgesic effects of sterile water injection in the management of low back pain during labor: A systematic review and meta-analysis

Abstract

Background: Sterile water injections (SWIs) as a non-pharmacologic and cost-effective method have been adopted to relieve low back labor pain (LBLP).

Objective: To compare the efficacy of intradermal and subdermal SWIs in the treatment of LBLP.

Search strategy: Three databases (PubMed, Cochrane Library, and ScienceDirect) were searched to find relevant articles using two terms, "labor" and "sterile water".

Selection criteria: Studies reporting women with LBLP treated by intradermal or subdermal SWIs in the low back area were included.

Data collection and analysis: Mean differences with 95% confidence interval (CI) and relative risk with 95% CI were used to estimate VAS score and cesarean section rate, respectively.

Main results: Except for 10 min, the patients in the intradermal or subdermal SWI group experienced considerable pain reduction compared with the control group for 30-45, 60, and 90 min. Directly comparing intradermal and subdermal SWI groups, the subdermal injection group had significantly better pain relief than the intradermal injection group only at 10 min after treatment.

Conclusions: Both intradermal and subdermal SWIs could reduce LBLP at 30-90 min. The subdermal SWI had significantly better LBLP relief than the intradermal injection only at 10 min after treatment.

Keywords: intradermal; labor; low back pain; sterile water injection; subdermal.