Effect of applying cold gel pack on reduction of postoperative pain in cesarean section, low midline skin incision: A randomized controlled trial.

Abstract

The present study aims to investigate the efficacy of cryotherapy in pain reduction following low midline cesarean section. This randomized controlled trial was conducted at the Department of Obstetrics and Gynecology, Thammasat University Hospital, Thailand from December 2019 to February 2020. Participants were term pregnant women who were indicated for low midline cesarean section. The control group received standard postoperative care while cold pack was applied to the intervention group for 6h after the operation. The primary outcome was the postoperative visual analog scale (VAS) score in both the control and intervention groups. The secondary outcomes consisted of the amount of intravenous pain reliever each participant required and the length of hospital stay. All 100 pregnant women were recruited into the study. They were equally allocated into intervention or control groups. Both groups underwent cesarean section under spinal anesthesia. The demographic characteristics of both groups were comparable. VAS of intervention and control group were 3.2 ± 2.4 versus 5.3 ± 2.2, 3.0 ± 2.4 versus 5.6 ± 2.0, 2.0 ± 2.3 versus 5.3 ± 2.2, and 1.1 ± 1.7 versus 4.8 ± 2.4 at 6, 8, 12, and 24 h postoperatively (p-value <0.05), respectively. Moreover, the intervention group showed a statistically significantly lower number of participants who needed intravenous meperidine or tramadol (14% vs. 24%, p-value <0.05) and lower intravenous meperidine or tramadol usage than in control group (13.2 ± 0.9 vs. 19.9 ± 4.0mg, p-value <0.05). Cryotherapy could reduce postoperative pain from 6h to within 24 h of the postoperative period, as well as lower overall opioid requirement.