Adriana Amorim Francisco1, Sonia Maria Junqueira Vasconcellos De Oliveira2, Mary Steen3, Moacyr Roberto Cuce Nobre4, Eder Viana De Souza5. 1. Rua Napoleão de Barros, 754, São Paulo - SP, CEP 04024-002, Brazil. Electronic address: adriana.francisco@unifesp.br. 2. School of Nursing, University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar, 419, São Paulo, CEP 05403-000, Brazil. Electronic address: soniaju@usp.br. 3. School of Nursing and Midwifery, University of South Australia, 101 Currie St, Adelaide, SA 5001, Australia. Electronic address: mary.steen@unisa.edu.au. 4. Medical School, Clinical Epidemiology Unit, Heart Institute (InCor), University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar, 44, São Paulo, CEP 05403-904, Brazil. Electronic address: mrcnobre@usp.br. 5. School of Medicine, Municipal University of Sao Caetano do Sul, Av. Goiás, 3400, São Caetano do Sul, SP, CEP 09550-051, Brazil. Electronic address: eder.souza@uscs.edu.br.
Abstract
BACKGROUND: Ice-pack is widely used for alleviating postpartum perineal pain sustained after birth related perineal trauma. However, it lacks robust evidence on timing and frequency of applications, to ensure the effective and safe use of this therapy. AIMS: To evaluate if a 10min ice-pack application relieved postpartum perineal pain and if the analgesic effect was maintained for up to 2h. METHODS: A randomised controlled trial conducted from December 2012 to February 2013 with 69 primiparous women ≥18 years old, 6-24h postpartum, with perineal pain ≥3, who had not received anti-inflammatory medication or analgesics after childbirth, who were randomised to a single ice-pack application on the perineum for 10min or standard care. The primary and secondary outcomes were a reduction ≥30% in perineal pain intensity, immediately after the application and the maintenance of the analgesic effect for up to 2h, respectively. FINDINGS: Immediately post-intervention, the proportion of women whose perineal pain decreased ≥30% was significantly higher in the experimental group. Within 2h, there was no significant difference in the pain levels in both groups. Within 2h, for 61.9% and 89.3% of women in the experimental and control group, respectively, the perineal pain levels remained unchanged. For the remaining participants, perineal pain was increasing after an average time of 1h 45min and 1h 56min for the experimental and control groups, respectively. CONCLUSION: By applying an ice-pack for 10min to the perineum, effective pain relief is achieved, that is maintained for between 1h 45min and 2h.
RCT Entities:
BACKGROUND: Ice-pack is widely used for alleviating postpartum perineal pain sustained after birth related perineal trauma. However, it lacks robust evidence on timing and frequency of applications, to ensure the effective and safe use of this therapy. AIMS: To evaluate if a 10min ice-pack application relieved postpartum perineal pain and if the analgesic effect was maintained for up to 2h. METHODS: A randomised controlled trial conducted from December 2012 to February 2013 with 69 primiparous women ≥18 years old, 6-24h postpartum, with perineal pain ≥3, who had not received anti-inflammatory medication or analgesics after childbirth, who were randomised to a single ice-pack application on the perineum for 10min or standard care. The primary and secondary outcomes were a reduction ≥30% in perineal pain intensity, immediately after the application and the maintenance of the analgesic effect for up to 2h, respectively. FINDINGS: Immediately post-intervention, the proportion of women whose perineal pain decreased ≥30% was significantly higher in the experimental group. Within 2h, there was no significant difference in the pain levels in both groups. Within 2h, for 61.9% and 89.3% of women in the experimental and control group, respectively, the perineal pain levels remained unchanged. For the remaining participants, perineal pain was increasing after an average time of 1h 45min and 1h 56min for the experimental and control groups, respectively. CONCLUSION: By applying an ice-pack for 10min to the perineum, effective pain relief is achieved, that is maintained for between 1h 45min and 2h.