Evaluation of the efficacy of manual pressure and local cold spray application in reducing pain caused by human anti-D immunoglobulin injection in pregnant women: a randomized controlled study

The study aimed to determine the effect of manual pressure and local cold spray administration on pain intensity and satisfaction in reducing pain due to Human Anti-D Immunoglobulin injection administered to pregnant women. In this interventional, randomised controlled trial, the study population consisted of pregnant women with Rh incompatibility who were monitored in the pregnancy polyclinics of a city hospital between December 2023 and April 2024. The sample consisted of pregnant women who were prescribed Human Anti-D Immunoglobulin injection due to Rh incompatibility and met the inclusion criteria. The sample included 43 pregnant women in each group [Manual Pressure (MP), Local Cold Spray (LCS), Control Group (CG)], a total of 129 pregnant women. A Descriptive Information Form and The Fear of Pain Questionnaire-III (FPQ-III) were filled out before injection. During the injection, the standard IM injection procedure was applied to the CG, manual pressure was applied to the MP group, and cold spray was applied twice to the LCS group. After the injection, they were asked to mark the Visual Analog Scale (VAS) and Injection Satisfaction Scale (ISS) to evaluate their pain intensity. Sociodemographic and obstetric characteristics and pre-injection FPQ-III scores were similar across groups (p > 0.05). The mean VAS scores were significantly lower in the LCSG (2.80 ± 2.86) and the MPG (2.86 ± 2.52) compared to the CG (4.88 ± 3.17) (p < 0.001). Both manual pressure (Cohen’s d = 0.705) and local cold spray (Cohen’s d = 0.689) produced a moderate effect on pain intensity. No significant difference was observed between LCSG and MPG (p > 0.05). Although Intervention Satisfaction Scale (ISS) scores were higher in the intervention groups, the differences between groups were not statistically significant (p > 0.05). It was determined that the application of manual pressure and local cold spray before the injection reduced the injection pain in pregnant women but did not affect their satisfaction with the injection procedure. Trial Registration number and Date of registration: NCT06231719/ 11/30/2023 10:07.