Ice Packs Shrink Post-Op Pain, Narcotic Use

Cryotherapy can help reduce postoperative pain after abdominal surgery, according to a study presented at the 2013 annual meeting of the American College of Surgeons (ACS). When clinicians applied ice packs to surgical sites, patients reported less pain and used smaller amounts of narcotics compared with those given narcotics alone.

“I don’t think this is some kind of ‘miracle’ remedy, but it’s one more component in the armamentarium that health care providers can use to treat pain,” said co-author Viraj Master, MD, PhD, professor of urology at the Winship Cancer Institute of Emory University, in Atlanta.

Previous research has shown that cryotherapy could reduce pain following gynecologic, hernia and orthopedic surgeries. his was The new trial was the first in which clinicians employed ice packs after major abdominal surgery, Dr. Master noted. Ammara Abbasi, MD, a surgery resident at Harvard Medical School and Beth Israel Deaconess Medical Center, both in Boston, and the lead author of the study, presented the findings at the ACS meeting (JACS 2013;217:S131).

The investigators randomized 55 patients who had midline incisions from abdominal surgeries into two groups. The cryotherapy group (n=27) received ice packs for at least 24 hours, in addition to morphine. Ice was applied for no more than 30 minutes per hour. Clinicians administered morphine alone to the control group (n=28). On postoperative days 1 and 3, ice packs significantly reduced mean postoperative pain scores compared with the control group (P<0.005), based on twice-daily assessment on a visual analog pain scale. Patients in the cryotherapy group also consumed a smaller amount of narcotics, on average, one day after surgery compared with those in the control group (P=0.008). There was no difference in hospital length of stay between the two groups.

“I don’t think [ice packs are] supposed to replace medications,” Dr. Master said. Instead, they should be used to complement other analgesics. “Most interventions to reduce pain are going to be multimodal.”

Cryotherapy did not increase risks for burning skin, wound infection or other adverse events. Ice packs also are cheap, at no more than $2 per bag, Dr. Master said. “If we can get the community of surgeons and health care providers to use ice more frequently,” he said, “we’ve done our job.”