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Effect of acupressure on bowel function recovery after cesarean section: a randomized controlled trial

Obstetrics & Gynecology International Journal
Nisa Prueksaritanond MD,<sup>1,2 </sup>Sasiwimol Kunnitikorn MD,<sup>1</sup> Putsarat Insin MD, MSc,<sup>1,2</sup>

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Aim: This randomized controlled clinical trial aims to evaluate the effect of acupressure onrecovery of bowel function after cesarean section (CS).
Methods: Forty-eight pregnant women who underwent CS at Rajavithi Hospital betweenDecember 1, 2020, and June 30, 2021, were recruited and randomly assigned into twogroups: 24 participants in the study group and 24 participants in the control group. The studygroup received two acupressure sessions: one three hours after CS and another three hoursafter the initial session. The acupoint used was Zusanli (located on the stomach meridian,ST-36), and each acupressure session lasted 10 minutes. In contrast, participants in thecontrol group followed the standard feeding protocol without receiving acupressure. Theprimary endpoint measured was the time to the first flatus. Secondary endpoints includedthe time to the first bowel sound, first defecation, the severity of nausea/vomiting, lengthof hospital stays, and adverse events related to acupressure, including soreness, bruising,and discomfort.
Results: Participants in the acupressure group had a significantly shorter time to thefirst flatus, first bowel sound, first defecation, and experienced milder nausea/vomitingcompared to those in the control group. However, no statistically significant difference inthe length of hospital stays and no adverse events related to acupressure were observed.
Conclusions: Acupressure, a non-invasive, feasible, and safe approach, has demonstratedits effectiveness in promoting faster recovery of bowel function in women undergoingCS. Therefore, we recommended it as an adjunct postoperative care method to reduce theincidence of postoperative ileus after CS.


acupressure, zusanli, bowel function recovery, cesarean section, postoperative ileus