Effectiveness of auriculotherapy on anxiety during labor: a randomized clinical trial

ABSTRACT Objective: to evaluate the effectiveness of auriculotherapy on the anxiety of women during labor. Method: this is a randomized, parallel, triple-blind clinical trial. 102 parturients with gestational age ≥ 37 weeks, cervical dilatation ≥ 4 cm and two or more contractions in 10 min were selected and randomly assigned into three groups to receive auriculotherapy, placebo or control (routine care). Auriculotherapy was applied with crystal microspheres to the shenmen, uterus, neurasthenia area and endocrine points, and anxiety was assessed by the Hamilton Anxiety Rating Scale (HAM-A). Analyzes were performed using the Kruskal-Wallis, Generalized estimating equations, Chi-square and Fisher’s exact tests. Results: the groups showed no significant difference at baseline according to the HAM-A. After the intervention there was a significant increase in HAM-A scores at 120 min in the placebo versus auriculotherapy group (mean difference (MD) 3.62, confidence interval (CI) 0.42-6.81, p=0.0265) and control versus auriculotherapy group (MD 4.88, CI 1.87-7.88, p=0.0015). Conclusion: the parturients with auriculotherapy presented lower levels of anxiety according to the HAM-A score after the treatment when compared to the women from the other groups; this can represent alternative care in obstetric practice. Registration: n. RBR-47hhbj. RESUMO Objetivo: avaliar a efetividade da auriculoterapia sobre a ansiedade de mulheres durante o trabalho de parto. Método: trata-se um ensaio clínico randomizado, paralelo e triplo-cego. Foram selecionadas 102 parturientes com idade gestacional ≥ 37 semanas, dilatação cervical ≥ 4 cm e duas ou mais contrações em 10 minutos. As participantes foram divididas aleatoriamente em três grupos, para receber auriculoterapia, placebo ou controle (cuidados de rotina). A auriculoterapia foi aplicada com microesferas de cristais nos pontos shenmen, útero, área de neurastenia e endócrino, e a ansiedade avaliada pela Escala de Ansiedade de Hamilton (HAM-A). As análises foram realizadas por meio dos testes: Kruskal-Wallis, Generalized estimating equations, Qui-quadrado e exato de Fisher. Resultados: os grupos não mostraram diferença significativa pela HAM-A na admissão do estudo. Após a intervenção, com 120 minutos houve aumento significativo nas pontuações da HAM-A no grupo placebo versus auriculoterapia (diferença média (DM) 3,62, intervalo de confiança (IC) 0,42-6,81, p=0,0265) e controle versus auriculoterapia (DM 4,88, IC 1,87-7,88, p=0,