Effects of Auricular Acupressure Combined with Epidural Analgesia on Labor Pain: A Randomized Controlled Trial

Labor pain remains a significant challenge during childbirth. While epidural analgesia is highly effective, it is associated with limitations such as breakthrough pain, motor blockade, and epidural-related maternal fever. Auricular acupressure, a non-pharmacological complementary therapy derived from Traditional Chinese Medicine, may modulate pain perception through gate control theory and biochemical mechanisms. This randomized controlled trial assesses whether combining auricular acupressure with epidural analgesia provides superior pain control compared to epidural analgesia alone. Fifty nulliparous women at term requesting epidural analgesia were randomized to receive either true auricular acupressure at specific points (Shenmen, Subcortex, Genitalia, Sympathetic) or sham non-acupoints stimulation. Pain scores were assessed using a Visual Analog Scale at baseline (cervical dilation 2-3 cm), 30 min post-epidural, and at full cervical dilation (10 cm). Secondary outcomes included local anesthetic consumption, incidence of breakthrough pain, and epidural-related maternal fever, Apgar scores, and maternal satisfaction. The protocol emphasizes accurate acupoint localization, blinding procedures, and standardized outcome assessment to ensure reliable results.