Investigating the Effect of Acupressure on Shivering During a Cesarean Delivery in Women Who Were Previously Laboring With an Epidural

Labor Clinical Trial

Official title:

Effect of P6 Acupressure Stimulation on Shivering During Cesarean Section Under Epidural Anesthesia.

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT03497507
• Other study ID #: GCO 17-2495
• Status: Terminated
• Phase: N/A
• Start date: January 11, 2018
• Est. completion date: October 4, 2021

Study information

• Verified date: October 2022
• Source: Icahn School of Medicine at Mount Sinai
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Shivering during a cesarean section can be quite uncomfortable for the patient as well as make it difficult for the anesthesiologist to obtain vital signs. The researchers will investigate whether or not applying pressure to the P6 acupressure point during a cesarean section can treat shivering. The hypothesis is that shivering will be alleviated with acupressure.

Description:

The purpose of this study is to determine whether applying pressure to the left and right P6 acupoints can treat shivering in a patient undergoing a cesarean section. The hypothesis is that bilateral stimulation of P6 with pressure can stop or alleviate shivering. The primary endpoint is resolution of shivering within 15 minutes of applying bilateral pressure to P6 acupoints during a cesarean section. The secondary endpoints include: 1. Time to resolution of shivering 2. Degree of patient-reported improvement in shivering 3. Degree of practitioner-reported improvement in shivering 4. Assessment of skin irritation and/or pain at the site of acupressure vs control Patient information will be stored in a locked cabinet on labor and delivery, and that cabinet will be located in a T3-locked office. The link between subject ID and patient ID will be stored in a different office on labor and delivery, also under a T3 lock. Patients who are laboring with an epidural catheter and subsequently require a cesarean section will be selected. This patient population has a MUCH higher rate of shivering during the cesarean section as compared to patients who undergo elective scheduled cesarean sections under spinal anesthesia. By selecting this group, the investigators are not only increasing chances of identifying shivering but also decreasing variability between patient characteristics by limiting it to one type (only epidural and not spinal) and limiting the number of screen failures.

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 43
• Est. completion date: October 4, 2021
• Est. primary completion date: October 4, 2021
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Female
• Age group: 18 Years to 64 Years

Eligibility

Inclusion Criteria:

• a patient has to be classified as an American Society of Anesthesiology (ASA) physical status I, II, or III, laboring with an epidural catheter, and subsequently taken for a non-emergent cesarean section under epidural anesthesia with a core body temperature range of 35.5-38.0 degrees Celsius during shivering.

Exclusion Criteria:

• ASA status 4 or higher
• core body temperature lower than 35.5 or higher than 38.0
• thyroid disease
• systemic infection
• emergent cesarean section,
• a psychiatric, cognitive or medical condition that would compromise adherence to the protocol

Related Conditions & MeSH terms

• Cesarean Delivery
• Labor
• Shivering

Intervention

Device:
• Sham bracelet
Patients will wear bracelets on both hands
• Acupressure bracelet
Patients will wear bracelets on both hands.

Locations

Country	Name	City	State
United States	Icahn School of Medicine at Mount Sinai	New York	New York

Sponsors (1)

Lead Sponsor	Collaborator
Icahn School of Medicine at Mount Sinai

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Incidence of resolution of shivering at 15 minutes	Incidence of resolution of shivering within 15 minutes of applying bilateral pressure to P6 acupoints during a cesarean section.	up to 15 minutes
Secondary	Time to resolution of shivering	Time to resolution of shivering	up to 15 minutes
Secondary	Degree of resolution of shivering	Degree of patient-reported improvement in shivering as measured by Crossley & Mahajan shivering scale: 0 = no shivering;1 = no visible muscle activity but piloerection, peripheral vasoconstriction, or both are present (other causes excluded); 2 = muscular activity in only one muscle group; 3 = moderate muscular activity in more than one muscle group but no generalized shaking; 4 = violent muscular activity that involves the whole body.	up to 15 minutes
Secondary	Degree of practitioner-reported improvement in shivering	Degree of practitioner-reported improvement in shivering as measured by Crossley & Mahajan shivering scale: 0 = no shivering;1 = no visible muscle activity but piloerection, peripheral vasoconstriction, or both are present (other causes excluded); 2 = muscular activity in only one muscle group; 3 = moderate muscular activity in more than one muscle group but no generalized shaking; 4 = violent muscular activity that involves the whole body.	up to 15 minutes
Secondary	Number of participants with skin irritation	Number of participants with skin irritation at the site of acupressure obtained by patient self-reporting	up to 15 minutes
Secondary	Number of participants with pain	Number of participants with pain at the site of acupressure obtained by patient self-reporting	up to 15 minutes