Effect of applying cold gel pack on reduction of postoperative pain in cesarean section, low midline skin incision: A randomized controlled trial

Author(s):  
Pawitra Suwannalert ◽  
Athita Chanthasenanont ◽  
Densak Pongrojpaw
2020 ◽  
Author(s):  
Sileshi Abiy ◽  
Nugusu Ayalew ◽  
Zemedu Aweke ◽  
Akine Eshete ◽  
Getachew Mergia ◽  
...  

Abstract Background: Pain is one of the most common compliant and cause of distress in the perioperative period. The postoperative pain after cesarean section is believed to be of mild to moderate intensity lasting for up to 72 hours. Apart from patient preferences, number of factors affect choices of analgesia in a resource limited setting like Ethiopia. Availability of resources, a trained man power and inter-individual variation in pain threshold were among a factor affecting analgesia choices. Thus, this study aims to compare TAP block versus II/IH block for post cesarean delivery analgesia in resource limited areas where ultrasound guided block is not practiced.Method: A randomized controlled trial study were conducted in Dilla University teaching and referral Hospital found in southern Ethiopia. A pregnant women scheduled for elective cesarean section was randomized to either TAP block (n = 36) or II/IH block (n = 36) for postoperative pain management. Sample size were calculated using a G-power version 3.1.9.2 getting a total of 72 participants. Pain severity, total tramadol consumption and time to first analgesia request were asses’ during the first 72 hour postoperatively. Many Whitney U-test and independent t-test were used based on distribution of data. A Kaplan Meier analysis was to asses’ proportion of patients who did not require analgesia for 48hour follow up period.Result: The cumulative median tramadol consumption over 48hour were 100 mg for TAP group and 150 mg for II/IH (p = 0.018). The median tramadol consumption at 24hr. and 36 hr. were also lower in TAP group compared to II-IH (P < 0.05). There is no statistically significant difference between groups regarding time to first analgesia request (p > 0.05). The median pain score at 36hr. and 48hr. were lower in TAP group (3 and 4) compared to II-IH group (4 and 6) respectively (p < 0.05). There is no statistically significant difference between groups regarding the postoperative side effects and complication.Conclusion: Both II-IH and TAP block has comparable analgesic efficacy during the first 24hr. TAP block has a longer analgesic effectiveness compared to II-IH with an effect lasting for 48hr.


2019 ◽  
Vol 10 (2) ◽  
pp. 70
Author(s):  
Samah Nasser Abd El-Aziz El-Shora ◽  
Amina Mohamed Rashad El-Nemer

Background and aim: Hypotension during cesarean section (CS) under spinal anesthesia has been a subject of scientific study for more than 50 years and the search for the most effective strategy to achieve hemodynamic stability remains challenging. Aim: The study was carried out to apply leg wrapping technique for the prevention of spinal-induced hypotension (SIH) during CS.Methods: Randomized Controlled Trial design was utilized at cesarean delivery operating room Mansoura General Hospital in El-Mansoura City during the period from May 2018 to November 2018. A purposive sample of 88 pregnant women, assigned randomly to an intervention group (n = 44) in which their legs wrapped with elastic crepe bandage and control group (n = 44) in which no wrapping was done. Data collected for maternal, neonatal hemodynamic and signs of hypotension, the feasibility of application and cost analysis.Results: There was a statistically significant difference in the incidence of SIH and Ephedrine use among both groups (18.20% in leg wrapping group whereas 75% in control group). In addition, neonatal acidosis and NICU admission were less among leg wrapping group (11.40%, 9.10% respectively). Economically, leg wrapping technique was cost effective compared to the cost of the hospital regimen for treating SIH and admission to (NICU).Conclusion and recommendations: Leg wrapping technique was cost effective and an efficient method for decreasing SIH, neonatal acidosis and Ephedrine administration. It is recommended to apply leg wrapping technique in maternal hospitals' protocol of care for decreasing SIH during CS.


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