Abdominal Ice Packs for Pain Control and Reduction of Narcotic Use Following Laparoscopic Hysterectomy: A Randomized Controlled Trial
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Pain, Postoperative
- Sponsor
- Mayo Clinic
- Enrollment
- 142
- Locations
- 1
- Primary Endpoint
- Numeric Pain Intensity Scale
- Status
- Completed
- Last Updated
- 5 years ago
Overview
Brief Summary
The purpose of this study is to evaluate the effect of using ice packs on the abdomen immediately after laparoscopic hysterectomy surgery on pain control and narcotic pain medication use.
Detailed Description
Hysterectomy is one of the most common surgical procedures performed on women in the United States, with approximately 600,000 performed annually. The use of postoperative cooling as an adjuvant for post-operative pain control has previously been shown to be effective and safe in a variety of procedures, but has yet to be described for laparoscopic surgery. In contrast to laparotomy where the wound is a significant pain generator and direct application of ice is intuitive, in laparoscopic surgery much of the pain-generating tissue trauma is intraperitoneal and pelvic in nature, away from the abdominal wall. Ice pack use on the abdominal wall likely inhibits visceral afferent pain fibers via somatic afferent nerve cross-talk. Accordingly, applying ice to the abdominal wall and its somatic afferents may improve laparoscopic pain control, despite the lack of a significant abdominal wound. Our goal is to quantify narcotic use after hospital discharge following hysterectomy, and evaluate the effectiveness of abdominal ice packs as low cost adjuncts for pain control.
Investigators
Tatnai L. Burnett
Senior Associate Consultant
Mayo Clinic
Eligibility Criteria
Inclusion Criteria
- •Women undergoing robotic or conventional laparoscopic hysterectomy
Exclusion Criteria
- •Any opioid use within 2 weeks of surgery date
- •Planned post-operative ICU admission
- •Conversion of laparoscopic approach to laparotomy or any incision ≥4 cm
- •Regional anesthesia/analgesia, including tap block use
Outcomes
Primary Outcomes
Numeric Pain Intensity Scale
Time Frame: 12 hours post-operatively
Self-reported pain intensity scores (Numerical Pain Intensity Scale, 0-10 visual analog scale with 0 representing no pain and 10 representing the worst pain imaginable) assessed and documented a minimum every four hours post-operatively. Mean differences of pain intensity assessed between ice group and usual care group.
Mean Morphine Metabolic Equivalents (MME) Consumption: Inpatient Floor
Time Frame: an average of one day from entering hospital floor to discharge
Calculation of average patient MME from the time enter hospital floor to hospital discharge. Administered narcotics will be abstracted from the medical record and converted to total MME for analysis.
Secondary Outcomes
- Mean Morphine Metabolic Equivalents (MME) Consumption: Outpatient(2 weeks)
- Brief Pain Inventory Short Form - Postoperative Pain Severity(one day after surgery)