Auricular acupuncture as effective pain relief after episiotomy: a randomized controlled pilot study

  • Katarina Kličan Jaić
  • Tihana Magdić Turković
  • Maja Pešić
  • Ivka Djaković
  • Vesna Košec
  • Andro KošecEmail author
General Gynecology



Previously, pain treatment following episiotomy has relied on non-steroid anti-inflammatory drugs as analgesics, whose use during breastfeeding remains controversial due of their transfer to the child.


This was a pilot randomized parallel single-center study aiming to evaluate the effects of auricular acupuncture on pain relief after episiotomy. The primary outcome was reduction of pain intensity using visual analogue scale (VAS) scores during the first three postpartum days. The patients were allocated to either of the groups by using a heads–tails binary result coin toss method and the allocation was not masked. The study was completed after including 60 healthy women that underwent mediolateral episiotomy performed during vaginal delivery, with 29 receiving acupuncture therapy and 31 not receiving acupuncture therapy for pain relief. Oral analgesic therapy was made available per request for all patients.


This study showed that subjective experience of pain was significantly reduced in the acupuncture group on the second and third postpartum days (P = 0.004, P = 0.005, P = 0.22). There were no adverse effects of acupuncture noted.


Our findings confirm that auricular acupuncture therapy may be a valuable adjunct to analgesic therapy in patients undergoing episiotomy during vaginal delivery. The results prompt a question whether our current ‘best practice’ may yet be improved.


Auricular acupuncture Episiotomy Acupuncture Pain relief Analgesic therapy 


Author contributions

KKJ: protocol/project development, data collection or management, data analysis, manuscript writing/editing. TMT: protocol/project development, data collection or management, data analysis, manuscript writing/editing. M: protocol/project development, data collection or management, data analysis, manuscript writing/editing. ID: protocol/project development, data collection or management, data analysis, manuscript writing/editing. VK: protocol/project development, data collection or management, data analysis, manuscript writing/editing. AK: protocol/project development, data collection or management, data analysis, manuscript writing/editing.

Compliance with ethical standards

Conflict of interest

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Anesthesiology, Intensive Care Medicine and Pain ManagementUniversity Hospital Center Sestre MilosrdniceZagrebCroatia
  2. 2.Clinical Department of Gynecology and ObstetricsUniversity Hospital Center Sestre MilosrdniceZagrebCroatia
  3. 3.Department of Otorhinolaryngology and Head and Neck SurgeryUniversity Hospital Center Sestre MilosrdniceZagrebCroatia

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