Acupressure for postoperative pain after cesarean delivery: A meta-analysis

Cesarean delivery is a major abdominal surgery with high global prevalence, and effective postoperative pain management is crucial for maternal recovery and well-being. Acupressure, a non-invasive Traditional Chinese Medicine technique, offers potential benefits but lacks comprehensive evidence for post-cesarean pain.

To evaluate the efficacy and safety of acupressure for pain relief after cesarean.

Following PRISMA guidelines and MOOSE guidelines, nine randomized controlled trials (RCT; n = 712 participants) were identified from PubMed, EMBASE, and Cochrane Central (inception, August 2025).

Studies compared acupressure with sham/standard care in postpartum women aged 18 years or older. Primary outcome was pain intensity at 0-2, 3-6, and 7-24 h postoperatively.

Meta-analysis used random-effects models (Stata 17.0), calculating mean differences (MD).

Pooled results demonstrated significant pain reduction favoring acupressure across all time points: MD = -1.39 (95% confidence interval [CI] -1.96 to -0.83; I² = 91.5%) at 0-2 h, MD = -0.99 (95% CI -1.53 to -0.45; I² = 77.9%) at 3-6 h, and MD = -1.27 (95% CI -1.64 to -0.90; I² = 13.6%) at 7-24 h. No serious adverse events were reported in the included studies; however, adverse-event reporting was limited, and minor transient events such as bruising or tenderness were described in three trials.

Acupressure may reduce acute post-cesarean pain, particularly when LI4/SP6 acupoints are used, and may represent a promising non-pharmacologic adjunct within multimodal analgesia. However, the certainty of evidence was low, and the findings should be interpreted cautiously. Further high-quality, multicenter RCT with standardized protocols are needed to confirm these findings.

The review was registered with the PROSPERO International Prospective Register of Systematic Reviews (registration no.: CRD420251230973).