Comparison of application times for ice packs used to relieve perineal pain after normal birth: a randomised clinical trial.

Aims And Objectives: To compare the effect of an ice pack applied for 10, 15 and 20 minutes to relieve perineal pain after birth.

Background: Perineal pain after vaginal birth, with or without vaginal trauma, is one of the most common morbidities reported for postnatal women. Cryotherapy has been used in postpartum period to relieve perineal pain and investigated in several studies. However, cryotherapy treatment protocols in perineal care vary widely regarding temperature, frequency and duration of the application.

Design: A controlled trial, randomised for two groups and with a third group as a historical control.

Method: The intervention was carried out in a maternity hospital in São Paulo, Brazil. The study population consisted of three groups of 38 women who used an ice pack on the perineum, in a single application: group A-10 minutes; group B-15 minutes; group C-20 minutes (historical control from another clinical trial). Participants' perineal pain magnitude was evaluated through a numerical scale (0-10), at four different points: before the cryotherapy; immediately after and at 20 and 40 minutes after cryotherapy.

Results: After application of the ice pack, there was no statistical difference when comparing the perineal pain among groups in the second, third and fourth evaluations. Most of the postnatal women reported pain relief, with 72.8% reporting a decrease in pain >50%; 21.9% reported a decrease between 30-50%. All postnatal women subjected to cryotherapy were favourable to the procedure.

Conclusion: There is no difference in pain scores following ice pack application in three different times (10, 15 and 20 minutes) in women who report moderate or intense perineal pain after normal delivery.

Relevance For Clinical Practice: Ice treatment is safe, and application times of 10 or 15 minutes are as beneficial as an application time of 20 minutes to relieve perineal pain.