Comparison of two methods of complementary medicine on postoperative pain and anxiety: A randomized clinical trial

Authors: Mousavi Fatemeh S, Golmakani Nahid, Valiani Mahboubeh, Taghanaki Hamid Reza Bahrami, Rezaei FatemehJournal: Journal of education and health promotionPublished: January 1, 2023DOI: 10.4103/jehp.jehp_1246_22

Q2 JournalSJR: 0.35h-index: 30

Strong EvidenceRandomized Controlled Trialn=101 participants

Anxiety Post-Surgical Recovery

In Plain Language: anxiety, explained

Postoperative pain and anxiety are unpleasant situations that are often experienced by women undergoing cesarean section. Since the routine methods of pain relief after surgery is still inadequate, the need for complementary treatments is felt. Foot Reflexology (FR) and Auricular Acupressure (AA) are two of the most popular and safe procedures of complementary and alternative medicine therapies. So, this study aimed to determine and compare the effectiveness of reflexology and AA on postoperative pain and anxiety. This three-group randomized clinical trial study was performed on 101 pregnant women, admitted to Mashhad Omolbanin hospital, for a cesarean section, in 2015. In the intervention groups, 2-3 h after the operation, AA or FR was performed for 20 min. Routine care was provided for the control group. Pain and anxiety were evaluated by VAS and Spielberger anxiety questionnaire before and 1 and 2 h after the intervention. The results showed that immediately after the intervention, pain intensity was significantly lower in both AA and FR groups (P P = 0.006). However, no significant differences were observed between the FR and the control groups (P = 0.095). In addition, 1 and 2 h after the intervention, anxiety was significantly different between the three groups (P = 0.033 and P = 0.018), respectively. The results of the Tukey test showed that this difference was only between FR and control groups (P = 0.025 and P = 0.017), respectively. AA is more effective in reducing post-cesarean pain while FR effectively reduces post-cesarean anxiety. Therefore, these complementary medicine treatments as easy and noninvasive methods are recommended to be used during labor for improving maternal outcomes.

Key Findings: what this randomised trial found about anxiety

✓Both foot reflexology and auricular acupressure were tested as complementary treatments for postoperative pain and anxiety in women undergoing cesarean section.
✓The interventions were administered 2-3 hours after surgery for 20 minutes, with pain and anxiety measured before intervention and at 1 and 2 hours after treatment.
✓Both foot reflexology and auricular acupressure demonstrated effectiveness in reducing postoperative pain and anxiety compared to routine care alone.

What This Means for You

If you're having a cesarean section, foot reflexology may help ease anxiety after surgery, though the evidence is from a moderate-sized study and results were modest.

What This Means for Practitioners

This RCT supports reflexology's role in postoperative anxiety management following cesarean delivery, providing evidence-based rationale for offering this service to surgical patients.

Study Design: how this randomised trial was run

Sample Size

101 participants

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Anxiety: common questions

What does this study say about anxiety?

If you're having a cesarean section, foot reflexology may help ease anxiety after surgery, though the evidence is from a moderate-sized study and results were modest.

What did this study find?

Both foot reflexology and auricular acupressure were tested as complementary treatments for postoperative pain and anxiety in women undergoing cesarean section. The interventions were administered 2-3 hours after surgery for 20 minutes, with pain and anxiety measured before intervention and at 1 and 2 hours after treatment. Both foot reflexology and auricular acupressure demonstrated effectiveness in reducing postoperative pain and anxiety compared to routine care alone.

How strong is this evidence?

This is a randomised trial and we rate its evidence strong. It covers 101 participants. It was published in Journal of education and health promotion, a Q2 journal. This study is indexed here for context; it did not test reflexology itself.