Efficacy of Cold Gel Pack in Reducing Postoperative Pain in Cesarean Delivery at Sanpasitthiprasong Hospital: Randomized controlled trial

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Patchareeya Siripanthong
Piyawadee Wuttikonsammakit
Parinya Chamnan

Abstract

Objectives: To evaluate efficacy and safety of cold gel pack in adjunctive to standard pain control in reducing postoperative pain after Cesarean delivery
Materials and Methods: Between December 2019 and March 2020, 34 women who underwent Cesarean delivery under regional anesthesia with neuraxial opioid at Sanpasitthiprasong Hospital were recruited. They were randomized into two groups: 1) receiving adjunctive cold gel pack covering surgical wound at 2-hour postdelivery for 20 minutes (intervention group, n = 17) or 2) receiving standard pain control (control group, n = 17). Pain scores were assessed using visual analogue scale (VAS) at 2 hours (before intervention), 6 hours (4 hours after intervention) and 24 hours postdelivery. Data on additional analgesic drugs, possible complications, participant’s satisfaction were recorded. Pain scores were compared between treatment groups using student t-test and occurrence of complications compared using chi-square test.
Results: With comparable initial pain score, intervention group had significantly lower postoperative pain at 6 hours after Cesarean delivery than control group (mean pain score ± standard deviation 3.53 ± 2.12 and 5.44 ± 1.56 respectively, p = 0.005), but there was no difference at 24 hours postdelivery. Patients in both groups required similar amount of additional analgesia. There were no significant differences between groups in postpartum hemorrhage, length of hospital stays and surgical wound infection. There were moderate and high patient satisfaction similarly observed for the two groups. No adverse effect from intervention happened in the intervention group.
Conclusion: Adjunctive cold gel pack was efficacious in reducing postoperative pain at 6 hours after Cesarean delivery without safety concerns.

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