Intracutaneous Sterile Water Injections for Relief of Back Pain during Labor

Objective: To re-evaluate the role of intracutaneous sterile water injections as a method of back pain relief during labor compared to placebo. Patients and Methods: Randomized, double-blinded, placebo-controlled trial, where sixty laboring patients were randomly allocated into one of two groups. Group I (40 patients) received four injections of sterile water while group II (20 patients) received four injections of normal saline as a placebo intracutaneously to Michaelis rhomboid during active first stage of labor. Primary outcome was back pain scores according to visual analogue scale immediately before then 10, 45 and 90 minutes after the injections. Secondary outcomes were occurrence of fetal or maternal complications, requesting further analgesia, and acceptance of the technique by the participants for future labors. Results: Pain scores were similar between both groups at time of injections but significantly lower at 10, 45 and 90 minutes in group I compared to group II, with maximal difference at 10 minutes following injections. Also, participants requesting more pain relief were more among group II with a statistically significant difference. Moreover, significantly more participants of group I accepted this technique to be used in their future labors. No side effects or complications were reported throughout the study. Conclusions: Intracutaneous sterile water injection appeared to be a safe, effective, inexpensive and acceptable method of back pain relief during labor.