From: Judith Kurokawa
Abstracts added from Medline by Sabrina Cuddy
Abstract: To evaluate the analgesic effect of intradermal sterile water blocks,
272 women in labor complaining of severe low back pain were randomly
assigned to treatment with either sterile water or saline solution blocks.
Pain intensity was assessed on a visual analog scale, before the blocks
were given and again 1 and 2 hours later. The groups were equal with regard
to age, parity, fetal size, progression of labor, and initial pain scoring.
Pain scoring 1 and 2 hours after the blocks were given showed a
significantly higher degree of analgesia in the sterile water group. No
adverse effects were noted, and patient acceptability was high.
UI - 90310544 Ader L, Hansson B, Wallin G Parturition pain treated by
intracutaneous injections of sterile water Pain 1990 May;41(2):133-8
Abstract: Forty-five pregnant women in the first stage of labour presenting
with lower back pain were randomized into 2 groups. One group received
intracutaneous injections of sterile water in the lumbosacral region, while
the other group was given corresponding subcutaneous injections of isotonic
saline, regarded as a placebo treatment. In the group that received
intracutaneous sterile water injections the mean VAS score was
significantly more reduced compared to the placebo group at 10 min (P less
than 0.001), 45 min (P less than 0.02), and at 90 min (P less than 0.05)
after the treatment. The midwives' blind estimation of the effectiveness of
treatment was consistent with the VAS assessment. However, the requirement
of pethidine (meperidine) was similar in the 2 groups. The analgesic method
presented was found to be an effective treatment against lower back pain
during the first stage of labour and it is speculated that the mode of
action resembles acupuncture.
UI - 95037823 Reynolds JL, Intracutaneous sterile water for back pain in
labour. Can Fam Physician 1994 Oct;40:1785-8, 1791-2
Abstract: Intracutaneous sterile water appears to be a simple, effective, and
harmless technique for relieving back pain. This technique has been used to
relieve pain of renal colic, whiplash, and back pain in labour. Family
doctors often practise obstetrics in small or isolated units that have
limited options for pain relief in labour. This technique is simple, is
easy to learn, and appears effective for relieving back pain, which
complicates about one third of all labours.
UI - 90143792 Lytzen T, Cederberg L, Moller-Nielsen J - Relief of low
back pain in labor by using intracutaneous nerve stimulation (INS) with sterile
water papules. Acta Obstet Gynecol Scand 1989;
Abstract: Eighty-three women experiencing low back pain in the 1st stage of
labor were given intracutaneous nociceptive stimulation (INS) by means of
sterile water papules injected intracutaneously over sacrum. There was
instant and complete relief of the low back pain in all but 6 women, this
effect lasting in many cases as long as 3 h, after which INS could be
repeated. A reduction in total pain-score from 6.05 to 2.92 was seen after
1 hour with no further analgesia given, and half the women required no
further analgesia during the 1st stage. The method was well tolerated and
67 of the 83 women said they would like to have INS analgesia for their
next delivery. Possible mechanisms behind the analgesic effect of INS are
discussed.
UI - 77213725 Melzack R - Prolonged relief of pain by brief, intense
transcutaneous somatic stimulation. Pain 1975 Dec;1(4):357-73
UI - 77193009 Fox EJ, Melzack R Transcutaneous electrical stimulation
and acupuncture: comparison of treatment for low-back pain. Pain 1976 Jun;2(2
:141-8
Byrn C, Olsson I, Falkheden L, et al; Subcutaneous sterile water injections
for chronic neck and shoulder pain following whiplash injuries. The Lancet
1993 Feb; Vol 341:449-52
Abstract: In many cases of whiplash injury symptoms persist and do not respond
to treatment. There is uncontrolled evidence to suggest that intracutaneous
injections of sterile water might help. Since that route may be
unacceptable to patients the subcutaneous route is used in the randomised
trial reported here. 40 patients with whiplash syndrome, mean age 46 years
(24-73) were given subcutaneous injections of 0.3-0.5 ml sterile water or
saline over tender and trigger points in the neck and shoulder. A maximum
of three treatments were given during the first two months of the study andthe patients were followed up for 8 months. The accidents had occurred 4-6
years previously. X-ray examinations revealed no traumatic spinal lesions.
Neck mobility and pain levels were evaluated by a physiotherapist
immediately before and after the first treatment and after 1, 3, and 8
months. After 3 months, the mean total mobility of the cervical spine had
increased by 39 degrees in the sterile water group and 6 degrees in the
saline group (p < 0.05). Minimum and maximum levels of pain in the weeks
just before treatment were evaluated by a visual analogue scale from 0 to
10. After 3 months the minimum pain level had fallen from 2.2 to 1.4 in the
sterile water group but was not reduced in the saline group (p < 0.02); the
maximum had fallen from 8.1 to 3.8 in the sterile water group and from 8.3
to 7.5 in the saline group (p < 0.001). After 3 months, 19 of 20 patients
in the sterile water group assessed their condition as generally improved
but only 6 in the saline group felt that they had got better. After 8
months there were still significant differences for minimum pain score and
for mobility but not for maximum pain or for self-assessment of
improvement.
Garvy T, Marks M, Wiesel S; A prospective, randomized double-blind
evaluation of trigger-point injection therapy for low-back pain.
Spine 1989;vol 14:962-64
Parsons, CM, Goetzl FR; Effect of induced pain on pain threshold.
Proc Soc Exp Biol NY 1945;50: 327-29
Gammon GD, Starr I. Studies on the relief of pain by counterirritation.
J Clin Invest 1941;20;13-20
Sand T, Bovim G, Helde G. Intracutaneous sterile water injections do not
relieve pain in cervicogenic headache. Acta Neurol Scand 1992: 86(5): 526-28
Abstract: Intracutaneous sterile water injections have been reported to relieve
acute labor pain and cervical pain in whip-lash patients. A double blind
cross-over trial has presently been conducted in 10 women with cervicogenic
headache in order to investigate whether sterile water injections were
effective in this disorder. No benefit was observed for either treatment
(isotonic saline or sterile water), neither on pain during the first 14
days nor on neck mobility. We conclude that intracutaneous sterile water
injections is not effective in cervicogenic headache.
BIBLIOGRAPHY
UI - 91241184 Trolle B, Moller M, Kronborg H, Thomsen S The effect of
sterile water blocks on low back labor pain. Am J Obstet Gynecol 1991
May;164(5 Pt 1):1277-81