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    Ice packs and cooling gel pads versus no localised treatment for relief of perineal pain: A randomised controlled trial

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    Authors
    Steen, Mary
    Marchant, Paul
    Affiliation
    Royal College of Midwives/University of Central Lancashire ; Leeds Metropolitan University
    Publication Date
    2007-06-01
    
    Metadata
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    Abstract
    Background: Trauma to the perineum is extremely common during childbirth and the intensity of perineal pain has been reported to vary from being mild to very severe in nature. Aim: To evaluate the effectiveness of two localised cooling treatments (ice pack and cooling gel pad) compared with a no localised treatment group at relieving perineal pain. Method: A randomised controlled trial conducted in a large maternity unit in the north of England and followed up in women's own homes in which 450 women who had either undergone a normal or instrumental delivery that required suturing of an episiotomy or second-degree tear were randomly assigned to three treatment groups. Results: The response rate was 316 out of 450(71%). Perineal pain was most severe when sitting compared to lying down or walking and there was a significant difference between the three groups in estimates of overall pain when sitting on day four (Kruskal-Wallis test,df=2 p=0.01). Estimates of overall pain were lower in the gel pad group, and the difference between the three groups was significant at days five and day ten (Kruskal-Wallis test,df=2 p=0.02, p=0.01). On days two, three and five, significance was measured when making a binary comparison of reported 'moderate' or 'severe' pain with 'none' or 'mild' (chi-square test, p=0.04,p=0.04, p=0.02). Using a summary pain measurement, mothers experienced fewer painful days in the gel pad group but this did not reach statistical significance (Kruskal-Wallis test, df=2 p=0.26). The use of analgesia was reported to be similar in all three groups. Maternal satisfaction with their overall care was rated more highly in the gel pad group when compared to the two other groups (Kruskal-Wallis test, df=2 p>0.001). Conclusions: Cooling treatments can alleviate pain when compared to no localised treatment. Women appeared to find the cooling gel pad to be a more acceptable treatment.
    Citation
    Evidence-Based Midwifery, 2007, 5(1), pp. 16-22
    Publisher
    TenAlps
    Journal
    Evidence-Based Midwifery
    URI
    http://hdl.handle.net/10034/48247
    Additional Links
    http://www.rcm.org.uk/magazines/ebm/
    http://www.rcm.org.uk/magazines/ebm/ebm-issues-2007/ice-packs-and-cooling-gel-pads-versus-no-localised-treatment-for-relief-of-perineal-pain-a-randomise/?locale=en
    Type
    Article
    Language
    en
    Description
    This article is not available through ChesterRep. The full-text is available at http://www.rcm.org.uk/magazines/ebm/ebm-issues-2007/ice-packs-and-cooling-gel-pads-versus-no-localised-treatment-for-relief-of-perineal-pain-a-randomise/?locale=en
    ISSN
    1479-4489
    Sponsors
    NHS Executive Northern & Yorkshire Research Fellowship; Smith & Nephew Nursing Foundation Research Fellowship
    Collections
    Health and Social Care

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