Scalise PN, Koo DC, Durgin JM, Truche BS, Staffa SJ, Greco C, Solodiuk J, Lee EJ, Demehri FR, Kim HB. Cold Therapy for Pain Control in Pediatric Appendectomy Patients: A Randomized Controlled Trial.
J Pediatr Surg 2024:S0022-3468(24)00172-6. [PMID:
38570264 DOI:
10.1016/j.jpedsurg.2024.02.036]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 02/26/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE
Topical ice has been shown to reduce pain scores and opioid use in adults with midline abdominal incisions. This study was designed to evaluate the efficacy of a cold therapy system in children following laparoscopic appendectomy.
METHODS
Patients 7 years and older who underwent laparoscopic appendectomy at our institution from December 2021-September 2022 were eligible. Patients were randomized to standard pain therapy (control) or standard plus cold therapy (treatment) utilizing a modified ice machine system with cool abdominal pad postoperatively. Pain scores on the first 3 postoperative days (PODs), postoperative narcotic consumption, and patient satisfaction were analyzed.
RESULTS
Fifty-eight patients were randomized, 29 to each group. Average survey response rate was 74% in control and 89% in treatment patients. There was no significant difference in median pain scores or narcotic use between groups. Cold therapy contributed to subjective pain improvement in 71%, 74%, and 50% of respondents on PODs 1, 2, and 3 respectively.
CONCLUSION
A majority of patients reported cold therapy to be a helpful adjunct in pain control after appendectomy, though it did not reduce postoperative pain scores or narcotic use in our cohort - likely due to this population's naturally expedient recovery and low baseline narcotic requirement.
TYPE OF STUDY
Randomized Controlled Trial.
LEVEL OF EVIDENCE
Level I.
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