Cold Therapy for Pain Relief in Postoperative Cesarean Section: Randomized Controlled Trial
Chaowalit M, MD1, Pongrojpaw D, MD1, Chanthasenanont A, MD1, Pattaraarchachai J, PhD2, Bhamarapravatana K, PhD3, Suwannarurk K, MD1
Affiliation : 1 Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathumtani, Thailand 2 Chulabhorn International College Medicine, Thammasat University, Pathumtani, Thailand 3 Department of Preclinical Science, Faculty of Medicine, Thammasat University, Pathumtani, Thailand
Background : Cold therapy decreases tissue blood flow by causing vasoconstriction, reduces tissue metabolism, oxygen demands,
inflammation and muscle spasm. It also causes alteration of nerve conduction velocity and inhibitation of nociceptors.
Objective : To study the effectiveness of cold therapy for reducing postoperative pain in pregnant women who underwent cesarean
section.
Materials and Methods: Pregnant women who had indication for cesarean section were selected via inclusion criteria. The
participants were randomized into study and control group with simple random sampling methods. Cold pack gel was applied at
2 hours after operation for 6 hours of duration. The visual analog scale (VAS) score was recorded at 2, 6, 12 and 24 hours
postoperatively.
Results : Primary outcome measure was the visual analog scale (VAS) at 2, 6, 12 and 24 hours after surgery. Mean of VAS scores at
6 hours and 12 hours after surgery in the study group had statistically lower than the control group. Firstly, there was no difference
at 24 hours after surgery. After the second analysis was done by repeated ANCOVA, mean of VAS scores at 6 hours, 12 hours and
24 hours after surgery in the study group were lower than the control group with statistical difference. For the secondary outcomes,
meperidine consumption within 24 hours postoperative in study group had statistically decreased. No difference of time for the
first dose of meperidine requirement and length of hospital stay.
Conclusion : Cold pack gel could be another therapeutic option for postoperative pain management. In the present study, intervention
group had reduced their pain scores at 6 and 12 hours after surgery and had reduced the narcotic drugs consumption.
Keywords : Cold therapy, Pain, Cesarean section
