Minimizing Post-surgical Pain and Narcotic Administration Through Cryotherapy
Condition: Urologic Surgical Procedure
MeSH terms: Pain, Postoperative
Study type: Interventional

Summary: 
      Postoperative pain is an unavoidable consequence of open abdominal surgery. Although
      cryotherapy, the application of ice to a surgical wound site, has been shown to be effective
      in reducing postoperative pain in orthopedic, gynecologic, and hernia operations, it has not
      been assessed in patients who undergo major open abdominal operations. We hypothesized that
      patients who receive cryotherapy would report lower pain scores as a primary outcome measure.
      This would result in less narcotic analgesia usage, and shorter hospital stays as secondary
      outcome measures.
    

Detailed description: 
      Objectives:

      This study will attempt to assess the impact of cryotherapy on post-surgical inflammation and
      narcotic use. End-points for the study will be patient use of narcotics and pain level,
      regularly measured by nursing staff.

      Patient Selection:

      This study will accept all consecutive consenting patients who visit the Grady Hospital and
      Emory University urology clinics who require abdominal surgery.The study will require 55
      patients, based on prior power calculations.

      Registration/Randomization:

      Because this study will enroll all consenting patients, no registration is required. Patients
      will be enrolled by their urologist during a standard visit. With consent, the urologist will
      direct the patient to the researcher. Patients will be randomized to either cryotherapy or no
      adjunctive therapy following abdominal surgery.

      Therapy:

      Patients in the cryotherapy study group will have ice packs placed on their abdominal wound
      for 24 hours following surgery.After 24 hours, patients had the option of using ice packs for
      as long as they wished.

      Patient Assessment:

      Patients will be assessed by the nursing staff as they would otherwise be assessed
      postsurgically.

      Data Collection:

      During recovery time in the hospital, nurses will monitor both groups of patients as they do
      all patients. As with all patients, nurses will ask about pain levels and check the amount of
      narcotics you require for pain control. This study will not require any additional effort on
      patients' part. Once they are discharged, patient participation in the study will be
      complete.
    

Intervention name(s): Ice pack
Intervention type(s): Other
Intervention description(s): Cryotherapy was applied via reusable ice bags filled with ice. Ice packs were immediately applied after the dressing was placed on the wound. The ice pack maintained in place for a continuous 24 hours adn was refilled as needed. After twenty-four hours, patients had the option of using ice packs for as long as they wished. The duration of ice pack usage was noted.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: abdominal surgery; cryotherapy; pain score; narcotic utilization