Network meta-analysis of randomized controlled trials comparing the effectiveness of different treatments in reducing amniocentesis-associated pain and anxiety

BMC Pregnancy Childbirth. 2023 Nov 21;23(1):807. doi: 10.1186/s12884-023-06094-3.

Abstract

Objective: This network meta-analysis compared different methods to determine which is most efficient at lowering pain and anxiety in women undergoing amniocentesis.

Method: We looked through all published randomized controlled trials in the databases PubMed, Scopus, Web of Science, Cochrane, and EM base. Anxiety and pain were the predominant results. We used the R software version 4.2.1 to analyze the data.

Results: We included a total of 20 studies, with sample sizes ranging from 60 to 570. Virtual reality was the most effective strategy for lowering pain during AC [MD = -1.30, 95% CI (-2.11, -0.49)]. In addition, paracetamol use was the most successful approach for lowering pain following AC [MD = -1.68, 95% CI (-1.99, -1.37)]. The use of H7 acupressure, however, was the strategy that significantly reduced anxiety following AC [SMD = -15.46, 95% CI (-17.77, -13.15)].

Conclusion: The most effective method for reducing pain is the combination of virtual reality with paracetamol. Whereas, the most effective way to reduce anxiety is to combine an ice gel pack with H7 acupressure before applying AC.

Keywords: Amniocentesis; Anxiety; Network meta-analysis; Pain.

Publication types

  • Meta-Analysis

MeSH terms

  • Acetaminophen* / therapeutic use
  • Amniocentesis* / adverse effects
  • Anxiety / etiology
  • Anxiety / prevention & control
  • Female
  • Humans
  • Network Meta-Analysis
  • Pain / etiology
  • Pain / prevention & control
  • Pregnancy
  • Randomized Controlled Trials as Topic

Substances

  • Acetaminophen