Prospective Evaluation of Post-Operative Pain and Erythema Stratified By Anti-Slip Bed Surface

Abstract

Study Objective To assess differences in post-operative pain and erythema on a variety of anti-slip surfaces after minimally invasive gynecologic surgery Design Prospective randomized controlled trial with a minimum 6-week post-operative follow up Setting Patient positioning with Trendelenburg. Patients or Participants Patients undergoing major laparoscopic or vaginal surgery (hysterectomy or surgery >2 hours) were randomly assigned to one of three anti-slip surfaces: Pink Pad, Action O.R. Overlay (gelpad) or Olympic Vac-Pac (beanbag) from 6/2018-12/2019. 159 patients were enrolled with 148 found to be eligible. Interventions Patients were randomized 1:1:1 one of the three anti-slip surfaces. Measurements and Main Results Patients were pre-operatively assigned to one of three anti-slip surfaces. Pain was assessed on a standard 1-10 scale and erythema was assessed as a binary, present or absent. Pain was assessed in pre-operative holding and as the first pain score after surgery by the post anesthesia care unit nurse. Erythema was assessed in pre-operative holding and immediately after the operation. The pre-operative pain and erythema scores were not significantly different based on Tukey's multiple comparisons and proportion test respectively. Post-operative back pain was significantly less in the Pink Pad group versus the gelpad (0.96 vs. 2.40 points, p=0.036). Post-operative erythema was significantly less common in the Pink Pad group versus the beanbag group (6.2% vs. 30% respectively, p=0.017). Conclusion While overall post-operative pain control was excellent, there was a significantly less pain in the Pink Pad group versus the gelpad group. This finding presents a novel opportunity to limit the narcotic requirement after minimally invasive gynecologic surgery. Given the difference in post-operative erythema between the Pink Pad and beanbag, further study is warranted to assess the role of bed surface and skin irritation. To assess differences in post-operative pain and erythema on a variety of anti-slip surfaces after minimally invasive gynecologic surgery Prospective randomized controlled trial with a minimum 6-week post-operative follow up Patient positioning with Trendelenburg. Patients undergoing major laparoscopic or vaginal surgery (hysterectomy or surgery >2 hours) were randomly assigned to one of three anti-slip surfaces: Pink Pad, Action O.R. Overlay (gelpad) or Olympic Vac-Pac (beanbag) from 6/2018-12/2019. 159 patients were enrolled with 148 found to be eligible. Patients were randomized 1:1:1 one of the three anti-slip surfaces. Patients were pre-operatively assigned to one of three anti-slip surfaces. Pain was assessed on a standard 1-10 scale and erythema was assessed as a binary, present or absent. Pain was assessed in pre-operative holding and as the first pain score after surgery by the post anesthesia care unit nurse. Erythema was assessed in pre-operative holding and immediately after the operation. The pre-operative pain and erythema scores were not significantly different based on Tukey's multiple comparisons and proportion test respectively. Post-operative back pain was significantly less in the Pink Pad group versus the gelpad (0.96 vs. 2.40 points, p=0.036). Post-operative erythema was significantly less common in the Pink Pad group versus the beanbag group (6.2% vs. 30% respectively, p=0.017). While overall post-operative pain control was excellent, there was a significantly less pain in the Pink Pad group versus the gelpad group. This finding presents a novel opportunity to limit the narcotic requirement after minimally invasive gynecologic surgery. Given the difference in post-operative erythema between the Pink Pad and beanbag, further study is warranted to assess the role of bed surface and skin irritation.