Pengaruh Masase pada Punggung Terhadap Intensitas Nyeri Kala I Fase Laten

Persalinan Normal Melalui Peningkatan Kadar Endorfin

Yeni Aryani, Masrul ., Lisma Evareny
Abstract

Abstrak
Nyeri saat persalinan merupakan proses yang fisiologis. Sebanyak 12% - 67% wanita merasa
khawatir dengan nyeri yang akan dialami saat persalinan. Salah satu upaya untuk mengurangi
nyeri persalinan adalah dengan masase. Tujuan Penelitian ini untuk mengetahui pengaruh
masase pada punggung terhadap intensitas nyeri kala I fase laten persalinan normal melaui
peningkatan kadar endorfin. Ini merupakan suatu penelitian experimental dengan post test only
control group design yang dibagi atas kelompok perlakuan yang melakukan masase pada
punggung dan kelompok kontrol yang tidak masase. Intensitas nyeri dinilai dengan kuisioner
dan kadar endorfin diukur dengan human beta endorfin Elisa Kit. Data dianalisis menggunakan
uji t-test independent dan korelasi Spearmen. Hasil penelitian ini ditemukan ibu bersalin yang
dimasase memiliki intensitas nyeri lebih rendah 29.62 point dari pada yang tidak dimasase nilai
p=0.001, ada pengaruh masase terhadap intensitas nyeri kala I persalinan normal. Ibu bersalin
yang dimasase memiliki endorfin lebih tinggi dari pada yang tidak dimasase sebesar 142.82
pcg/mlnilai p=0.001 ada pengaruh masase terhadap kadar endorfin ibu bersalin normal. Ada
korelasi kadar endorfin dengan penurunan intensitas nyeri dengan nilai r= 0,795 dan nilai
p=0.001. Kesimpulan penelitian ini adalah masase pada punggung berpengaruh terhadap
intensitas nyeri dan kadar endorfin ibu bersalin kala I fase laten persalinan normal serta kadar
endorfin berkorelasi dengan intensitas nyeri kala I fase laten persalinan normal.
Kata kunci: masase pada punggung, intensitas nyeri, kadar endorfin.
Abstract
Pain in delivery is a physiological process. About 12% - 67% of women feel the pain during
delivery. One of the ways to reduce pain during delivery process is to massage mothers back.
The objective of this research was to determine the effect of massage on the back to the pain
intensity in normal delivery based on the level of endorphin. This study was an experimental
study with post test only control group design by massaging mothers back in normal delivery
process of primiparous phase I for 30 minutes. Data collection was done for three months. The
subject were choosen randomly block with 52 respondents. Data processing was done based on
the Independent t-test and Spearmen Correlation. The results of this study shows that mothers

who have massage on the back before delivery process, feel lower pain intensity in 29.62 points
than those who do not have massage. The result of statistical test was p =0.001, so, the massage
reduces the pain intensity. Mothers who have massage, get their endorphin increased as much as
142.82 PCG/ml compared to mothers who did not have massage. There was a correlation
between the increase of endorphin level with the reduction of pain intensity. The result of
statistical test shows that there is a strong correlation between the endorphin level with pain
intensity with a value,r=0.795andp=0.001. It can be conluded that massage on the back can
reduce pain intensity in normal delivery and increase the leve lof endorphin. Furthemore, there is
a strong correlation between the increase of endorphin level with pain intensity in normal
delivery. It is recommended that massage on the back can be done regularly in every normal
delivery. Keywords: massage on the back, pain intensity, level of endorphin

Nonpharmacologic relief of pain during labor: Systematic

reviews of five methods
Cited in Scopus: 109
Penny P. Simkin, MaryAnn O'Hara
American Journal of Obstetrics and Gynecology, Vol. 186, Issue 5, S131S159
Published in issue: May 2002

Nonpharmacologic measures to reduce labor pain have been used throughout

history. Despite reports that some of these methods reduce pain, increase maternal
satisfaction, and improve other obstetric outcomes, they have received limited
attention in the medical literature and are not commonly available to women in
North America. The controlled studies of nonpharmacologic methods are limited in
number and sometimes provide conflicting results. This systematic review was
conducted to assess the safety and efficacy of the best studied techniques, as well
as to highlight areas in need of further research. Five comfort measures were
selected for review, based on these criteria: they have been evaluated with
prospective controlled studies and they require institutional support (eg, skills,
policies, equipment). These 5 methods included continuous labor support, baths,
touch and massage, maternal movement and positioning, and intradermal water
blocks for back pain relief. An extensive search of electronic databases and other
sources identified studies for consideration. Critical evaluation of controlled studies
of these 5 methods suggests that all 5 may be effective in reducing labor pain and
improving other obstetric outcomes, and they are safe when used appropriately.
Additional well-designed studies are warranted to further clarify their effect and to
evaluate their cost effectiveness. (Am J Obstet Gynecol 2002;186:S131-59.)

Epidural analgesia is used by more than half of laboring women, yet there is no
consensus about what unintended effects it causes. To evaluate the state of our
knowledge, we performed a systematic review of the literature examining the
unintended maternal, fetal, and neonatal effects of epidural analgesia used for pain
relief in labor by low-risk women. Our review included randomized and
observational studies appearing in peer review journals since 1980. Much of the
evidence is equivocal. Existing randomized trials are either small or do not allow
clear interpretation of the data because of problems with protocol compliance. In
addition, few observational studies control for the confounding factors that result
because women who request epidural are different from women who do not. There
is considerable variation in the association of epidural with some outcomes,
particularly those that are heavily practice-based. Despite this variation, there is
sufficient evidence to conclude that epidural is associated with a lower rate of
spontaneous vaginal delivery, a higher rate of instrumental vaginal delivery and
longer labors, particularly in nulliparous women. Women receiving epidural are also
more likely to have intrapartum fever and their infants are more likely to be
evaluated and treated for suspected sepsis. There is insufficient evidence to
determine whether epidural does or does not tend to increase the risk of cesarean
delivery or fetal malposition. Adverse effects on the fetus may occur in the subset of
women who are febrile. Women should be informed of unintended effects of
epidural clearly supported by the evidence, especially since epidural use is almost
always an elective procedure. Further research is needed to advance our
understanding of the unintended effects of epidural. Improved information would
permit women to make truly informed decisions about the use of pain relief during
labor. (Am J Obstet Gynecol 2002;186:S31-68.)

Acupuncture for labor pain management: A systematic review

Cited in Scopus: 46
Hyangsook Lee, Edzard Ernst
American Journal of Obstetrics and Gynecology, Vol. 191, Issue 5, p15731579
Published in issue: November 2004

Acupuncture is widely used to alleviate symptoms in a variety of painful

conditions. In obstetrics and gynecology, acupuncture has also been applied to a
range of conditions including labor pain. This systematic review aims to critically
evaluate the evidence on analgesic effect of acupuncture during labor.
Computerized literature searches of 7 databases were performed for randomized
clinical trials (RCTs) of acupuncture involving needle insertion for pain during labor.
Three RCTs were identified and their methodologic quality was generally good. Two
RCTs compared adjunctive acupuncture with usual care only and reported a
reduction of meperidine and/or epidural analgesia. One placebo acupuncture
controlled trial showed a statistically significant difference in both subjective and
objective outcome measures of pain. No adverse events were reported in any of the
trials. It is concluded that the evidence for acupuncture as an adjunct to
conventional pain control during labor is promising but, because of the paucity of
trial data, not convincing. Further research is warranted to clearly define its place in
labor pain management.