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Epizyotomi, bebeğin güvenli doğumunu sağlamak, perine tonüsünü korumak ve istenmeyen yırtıkları önlemek amacıyla yapılan insizyondur. Perineal ağrı, özellikle postpartum ilk 3 gün boyunca, hareket etme, idrar yapma ve defekasyon, emzirme gibi günlük aktiviteleri olumsuz etkilemektedir. Bu nedenle epizyotomiden kaynaklanan ağrı tedavi edilmelidir. Son yıllarda farmakolojik olmayan yöntemler ya tek başlarına ya da birlikte ağrıyı azaltmada etkili olmaktadırlar. Temel amaç ağrı tedavisinde analjezik kulla-nım oranını azaltarak yaşam kalitesini yükseltmektir. Bu çalışmalardan 2007- 2017 arasında olan özellikle non-farmakolojik yöntemlerin etkilerini inceleyen 17 çalışmaya ulaşılmıştır. Epizyotomi sonrası perineal ağrının giderilmesinde soğuk jel pedi ve buz paketi uygulamasının, düşük frekanslı Transkutan Elektriksel Sinir Stimülasyonu (TENS) ve yüksek frekanslı TENS’in, bilek-ayak akapunktur uygulamasının, lavanta-timolü ilave edilerek hazırlanan yıkama solüsyonunun, tarçın merhemi ve at-kuyruğu merheminin etkili olduğu, Düşük Doz Lazer Tedavisi (DDLT)’nin, kulak akapunktur uygulamasının etkili olmadığı saptanmıştır. Lavanta yağı ile hazırlanan oturma banyosunun bir çalışmada etkili olduğu saptanırken diğer çalışmada etkili olmadığı saptanmıştır. Epizyotomi sonrası perineal ağrının giderilmesinde en etkili yöntemlerin kanıt düzeyinde araştırılması, bu yöntemlerin kullanımı ile ilgili sağlık çalışanlarına danışmanlık yapılması önerilmektedir.
Epizotomy is an insection made with the aim of ensuring the safe birth of the baby, preserving the perineum tone and preventing unwanted fractures. Perineal pain, especially during the first 3 days of postpartum, has a negative impact on daily activities such as movement, urination and defecation, breastfeeding. Therefore, the pain caused by epizotomy should be treated. In recent years, non-pharmacological methods have been effective either alone or together in reducing pain. The main objective is to improve the quality of life by reducing the rate of analgesic use in pain treatment. 17 of these studies have been achieved, in particular, to study the effects of non-pharmacological methods between 2007 and 2017. In the removal of perineal pain after epizotomy, the application of cold gel pedi and ice package, low-frequency transcutanic electrical nerve stimulation (TENS) and high-frequency TENS, the application of arm-foot acapunktur, the washing solution prepared with the addition of lavanta-timol, the merchandise of the cranberries and at-cranberries, the low-dose laser therapy (DDLT) and the application of ear acapunktur are not effective. The seating bath prepared with lavender oil has been shown to be effective in one study, while it has not been found to be effective in another study. Research on the proof level of effective methods in removing perineal pain after epizotomy is recommended to consult health professionals regarding the use of these methods.
Episiotomy is an incision, it is used for to ensure the safe delivery of the baby, to maintain perineal tonus and to prevent unwanted tears. Perineal pain is adversely affects daily activities such as movement, urination, defecation and breastfeeding especially in during the first 3 days postpartum. Therefore pain resulting from episiotomy should be treated. In recent years, non-pharmacological methods are effective in reducing the pain alone or together. The main objective is to improve the quality of life by reducing the rate of analgesic use in the treatment of pain. It has been reached 17 studies from these studies specifically examining the effects of non-pharmacological methods between 2007- 2017. Cold gel pad and ice pack application, low frequency Transkütan Electrical Nerve Stimulation (TENS) and high frequency TENS, Wrist-ankle acupuncture application, lavender-timol added washing solution, cinnamon ointment and horse-tail ointment is effective, low dose laser therapy (LLLT), ear acupuncture was found to be ineffective for the removal of perineal pain after episiotomy. The sitz bath with lavender oil prepared has been found to be effective in a study and not effective in the other study. It is recommended that to investigation of at the level of evidence about the most effective methods, advising advising health professionals about the use of methods.
Field : Sağlık Bilimleri
Journal Type : Ulusal
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