title: Length of perineal pain relief after ice pack application: A quasi-experimental study.
abstract: BACKGROUND
  Ice pack is effective for alleviating postpartum perineal pain in primiparous women while multiparous women's levels of perineal pain appear to be poorly explored. Ice pack is a low-cost non-invasive localised treatment that can be used with no impact on breastfeeding. However, how long perineal analgesia persists after applying an ice pack is still unknown.
  
  
  OBJECTIVE
  To evaluate if perineal analgesia is maintained up to 2h after applying an ice pack to the perineum for 20min.
  
  
  METHODS
  A quasi-experimental study, using a pre and post-test design, was undertaken with a sample size of 50 multiparous women in Brazil. Data was collected by structured interview. The intervention involved a single application of an ice pack applied for 20min to the perineal area of women who reported perineal pain ≥3 by use of a numeric rating scale (0-10), with intact perineum, 1st or 2nd degree lacerations or episiotomy, between 6 and 24h after spontaneous vaginal birth. Perineal pain was evaluated at three points of time: before, immediately after and 2h after applying an ice pack.
  
  
  RESULTS
  Immediately after applying an ice pack to the perineal area, there was a significant reduction in the severity of perineal pain reported (5.4 vs. 1.0, p<0.0005), which continued for 1h 35min up to 2h after the local application.
  
  
  CONCLUSIONS
  Ice pack application for 20min is effective for alleviating postpartum perineal pain and continues to be effective between 1h 35min for up to 2h.
authors.affiliation: School of Nursing of University of Sao Paulo, SP, Brazil. Electronic address: carolinebosco@yahoo.com.br.
authors.forename: Caroline
authors.initials: C
authors.lastname: de Souza Bosco Paiva
authors.affiliation: Department of Maternal Child and Psychiatric Nursing, School of Nursing of University of Sao Paulo, SP, Brazil. Electronic address: soniaju@usp.br.
authors.forename: Sonia Maria
authors.initials: SM
authors.lastname: Junqueira Vasconcellos de Oliveira
authors.affiliation: School of Nursing of University of Sao Paulo, SP, Brazil. Electronic address: adrianaaf@usp.br.
authors.forename: Adriana
authors.initials: A
authors.lastname: Amorim Francisco
authors.affiliation: School of Nursing of University of Sao Paulo, SP, Brazil. Electronic address: renata_obstetricia@yahoo.com.br.
authors.forename: Renata Luana
authors.initials: RL
authors.lastname: da Silva
authors.affiliation: School of Nursing of University of Sao Paulo, SP, Brazil. Electronic address: edilainepbatista@gmail.com.
authors.forename: Edilaine
authors.initials: E
authors.lastname: de Paula Batista Mendes
authors.affiliation: School of Nursing and Midwifery, University of South Australia, SA, Australia. Electronic address: mary.steen@unisa.edu.au.
authors.forename: Mary
authors.initials: M
authors.lastname: Steen
mesh_terms: D000328:Adult; D016362:Analgesia, Obstetrical / Q000379:methods*; D001938:Brazil; D017679:Cryotherapy / Q000379:methods*; D036861:Delivery, Obstetric; D004841:Episiotomy; D005260:Female; D006801:Humans; D007053:Ice; D010146:Pain; D059408:Pain Management / Q000379:methods*; D010298:Parity; D010502:Perineum / Q000293:injuries*; D049590:Postpartum Period; D011247:Pregnancy; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007053:Ice
keywords: Cryotherapy; Pain management; Perineal pain; Postnatal care; Postpartum period