Evaluation of the Bonapace Method to reduce pain during childbirth



the evaluation of the bun Apache method a specific educational intervention to reduce pain during childbirth although pain during childbirth is not usually associated to tissue damage it is very intense it comprises of at least two components pain intensity and pain unpleasantness options to reduce pain are pharmacologic but have higher medical interventions and nonpharmacologic which show inconclusive are conflicting results the aim of this multicenter control study is to measure the effects on pain perception during labor and delivery of the bond apache method which specifically addresses pain modulation techniques compared to traditional childbirth training programs the bond apache method is based on three endogenous mechanisms the first is the central nervous system control which comprises breathing relaxation and mostly deviation of attention it modulates pain unpleasantness mostly the gate control theory is like massage and ambulation and this is a light massage of the painful areas this is a blockage of part of the message in the spine it modulates mostly pain intensity the third mechanism is the diffuse noxious inhibitory control also known as the danique system the Zdenek system consists of creating a second pain anywhere in the body this mostly modulates pain intensity so what happens when you create the second pain the signal goes to the brain the brain wants to attract attention and understand what the nature of the second pain is releases endorphins all over the body except in the zone where we create the second pain so we teach parents the father especially how to activate this mechanism through painful massage in acupressure points in the lower back in the hand and the foot and elsewhere the methodology of this study consists of women who evaluated the pain every 15 minutes during all phases of labor and delivery the two groups were the bond Apache method which was eight hours of training specifically on modulating pain and traditional childbirth training programs which were mostly which consisted mostly of information on childbirth and on delivery the results are a reduction of both pain intensity and pain unpleasantness of 45 and 46 percent and this reduction is present during all phases of labor and delivery for pain intensity in the last three phases of labor and delivery for pain unpleasantness this shows that nonpharmacologic approaches to reduce pain work they reduced both intensity and unpleasantness of pain at a level that is probably tolerable to most women future research should include randomized controlled trials that evaluate not only pain intensity and unpleasantness but also different obstetrical outcomes thank you

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