Cryotherapy for postoperative pain

Laura Kenyon, MD, University of Texas Southwestern Medical Center, discussed the findings from a randomized control trial during an oral session at AAGL’s 51st Global Congress on MIGS in Aurora, Colorado.

The study included patients at 2 large academic institutions undergoing outpatient laparoscopic hysterectomy via conventional laparoscopic technique with the minimally invasive gynecologic surgery team between February 2019 and November 2020. Patients with chronic pain, current opioid use more than 1 week, or requiring planned overnight hospitalization were excluded. Primary outcome data was available for 51 participants—24 control, 27 intervention.

For the ice pack group, ice packs were placed on patients’ abdomens in the operating room. Pain was assessed multiple times throughout the study via Visual Analog Scale (VAS). Narcotic requirement was assessed using morphine milligram equivalent (MME). MME requirements did not differ between groups (p=0.63). According to the findings, 84.8% of participants felt their pain was adequately controlled. All subjects were prescribed 20 tablets of oxycodone. On average, they used 2.9 (SD 3.4) tablets after discharge. Of participants, 87% said they would use again in the future and 82.6% would recommend ice to others.

Kenyon and her team concluded ice packs to be an acceptable supplement for postoperative management with high patient satisfaction and no adverse effects. It is worth noting, hoever, cryotherapy did not significantly impact postoperative reported pain or narcotic use. Providers caring for postoperative patients should be aware, Kenyon said, of the unintentional consequences of overprescribing opioids and should consider reducing the number of tablets prescribed, especially as there has been consistent evidence that shows patients require less than half the quantity prescribed.

In short, Kenyon and her team concluded that ice packs increased patient satisfaction and did not cause any adverse effects. They did not impact postoperative reported pain or narcotic use.

Reference

Kenyon L. Ice-Pop: Ice Packs for Post-Operative Pain, a Randomized Controlled Trial. Presented at: AAGL’s 51st Global Congress on MIGS ; December 3, 2022; Aurora, Colorado.