Lucila Coca Leventhal

Perineal analgesia with an ice pack after spontaneous vaginal birth: a randomized controlled trial.

INTRODUCTION This study evaluated the effectiveness of an ice pack applied for 20 minutes to alleviate perineal pain after spontaneous vaginal birth. METHODS We conducted a randomized controlled trial at the Amparo Maternal Birth Center in São Paulo, Brazil. Study participants included 114 nulliparous women divided into 3 groups (n = 38 per group): experimental (ice packs on the perineum), placebo (water packs at set temperature), and control (no treatment). RESULTS A numerical scale (0 to 10) was used for pain assessment. A comparison of the average pain at the beginning and after 20 minutes showed a significant reduction of pain (P < .001) in the 3 groups, and the experimental group had a lower average score for pain compared with the control group (1.6 versus 3.3, P = .032). DISCUSSION The use of ice packs for 20 minutes was effective for perineal pain relief after vaginal birth.

Ensaio clínico comparando três modalidades de crioterapia em mulheres não grávidas

O estudo teve como objetivo comparar tres modalidades de crioterapia em mulheres saudaveis e nao gravidas. Trata-se de um ensaio clinico randomizado, nao controlado, com 32 alunas do curso de graduacao de uma faculdade de enfermagem particular da cidade de Sao Paulo, divididas em tres grupos (gelo agua, gelo mole, gelo gel). Foram verificadas as temperaturas (axilar, coxa e das tres bolsas de gelo) entre zero e vinte minutos. As temperaturas das bolsas foram: gelo mole de 9°C negativos a 2°C, gelo agua de 0°C a 8°C e gelo gel de 11°C negativos a 2°C. Houve diferenca significativa entre as medias das temperaturas da coxa com 10 minutos (p=0,007), 15 minutos (p=0,003) e 20 minutos (p=0,005). O gel foi mais eficiente no resfriamento comparado aos outros dois metodos. As tres modalidades de crioterapia atingem a temperatura recomendada para analgesia e podem ser aplicadas em puerperas com dor perineal apos o parto normal.The objective of the present study was to compare three methods of cryotherapy in healthy non-pregnant women. This is a randomized controlled clinical trial that was conducted by 32 undergraduates of a private nursing college in the city of Sao Paulo, divided into three groups (iced water, soft ice, ice gel). The temperatures were verified (axillary, thigh, of the three ice packs) between zero and twenty minutes. The temperatures of the packs were the following: soft ice, from negative 9 degrees C to 2 degrees C; iced water, from 0 degrees C to 8 degrees C; and ice gel from negative 11 degrees C to 2 degrees C. There was a significant difference between the average thigh temperature values at 10 minutes (p = 0.007), 15 minutes (p = 0.003) and 20 minutes (p = 0.005). The gel was the most efficient cooling method. The three cryotherapy methods achieved the recommended temperature for analgesia and may be tested in women with perineal pain after childbirth.

Clinical trial comparing three types of cryotherapy in non-pregnant women

O estudo teve como objetivo comparar tres modalidades de crioterapia em mulheres saudaveis e nao gravidas. Trata-se de um ensaio clinico randomizado, nao controlado, com 32 alunas do curso de graduacao de uma faculdade de enfermagem particular da cidade de Sao Paulo, divididas em tres grupos (gelo agua, gelo mole, gelo gel). Foram verificadas as temperaturas (axilar, coxa e das tres bolsas de gelo) entre zero e vinte minutos. As temperaturas das bolsas foram: gelo mole de 9°C negativos a 2°C, gelo agua de 0°C a 8°C e gelo gel de 11°C negativos a 2°C. Houve diferenca significativa entre as medias das temperaturas da coxa com 10 minutos (p=0,007), 15 minutos (p=0,003) e 20 minutos (p=0,005). O gel foi mais eficiente no resfriamento comparado aos outros dois metodos. As tres modalidades de crioterapia atingem a temperatura recomendada para analgesia e podem ser aplicadas em puerperas com dor perineal apos o parto normal.The objective of the present study was to compare three methods of cryotherapy in healthy non-pregnant women. This is a randomized controlled clinical trial that was conducted by 32 undergraduates of a private nursing college in the city of Sao Paulo, divided into three groups (iced water, soft ice, ice gel). The temperatures were verified (axillary, thigh, of the three ice packs) between zero and twenty minutes. The temperatures of the packs were the following: soft ice, from negative 9 degrees C to 2 degrees C; iced water, from 0 degrees C to 8 degrees C; and ice gel from negative 11 degrees C to 2 degrees C. There was a significant difference between the average thigh temperature values at 10 minutes (p = 0.007), 15 minutes (p = 0.003) and 20 minutes (p = 0.005). The gel was the most efficient cooling method. The three cryotherapy methods achieved the recommended temperature for analgesia and may be tested in women with perineal pain after childbirth.

Crioterapia no pós-parto: tempo de aplicação e mudanças na temperatura perineal

We present a descriptive study based on the data from two clinical trials conducted at a maternity hospital in Sao Paulo, Brazil, in 2008 and 2009. This study aimed to describe perineal temperature after the application of an ice pack during the postpartum period. Three groups of 38 postpartum women (n=114 total) received an ice pack between 2 and 48 h after delivery. The results showed that after 10 minutes of cryotherapy, the mean perineal temperature varied between 13.3°C and 15.3°C, with a small reduction at the end of the 15- and 20-minute applications (2.4°C and 2.7°C, respectively). Women who received cryotherapy for 10 minutes reported a cool sensation and pain relief; after a session of 15 or 20 minutes, the women reported anesthesia and numbness. In conclusion, an ice pack applied for 10 minutes reduced the perineal temperature to the recommended levels for analgesia (10-15°C).

Cryotherapy after childbirth: the length of application and changes in perineal temperature

We present a descriptive study based on the data from two clinical trials conducted at a maternity hospital in Sao Paulo, Brazil, in 2008 and 2009. This study aimed to describe perineal temperature after the application of an ice pack during the postpartum period. Three groups of 38 postpartum women (n=114 total) received an ice pack between 2 and 48 h after delivery. The results showed that after 10 minutes of cryotherapy, the mean perineal temperature varied between 13.3°C and 15.3°C, with a small reduction at the end of the 15- and 20-minute applications (2.4°C and 2.7°C, respectively). Women who received cryotherapy for 10 minutes reported a cool sensation and pain relief; after a session of 15 or 20 minutes, the women reported anesthesia and numbness. In conclusion, an ice pack applied for 10 minutes reduced the perineal temperature to the recommended levels for analgesia (10-15°C).

La crioterapia en el posparto: el tiempo de aplicación y cambios en la temperatura perineal

We present a descriptive study based on the data from two clinical trials conducted at a maternity hospital in Sao Paulo, Brazil, in 2008 and 2009. This study aimed to describe perineal temperature after the application of an ice pack during the postpartum period. Three groups of 38 postpartum women (n=114 total) received an ice pack between 2 and 48 h after delivery. The results showed that after 10 minutes of cryotherapy, the mean perineal temperature varied between 13.3°C and 15.3°C, with a small reduction at the end of the 15- and 20-minute applications (2.4°C and 2.7°C, respectively). Women who received cryotherapy for 10 minutes reported a cool sensation and pain relief; after a session of 15 or 20 minutes, the women reported anesthesia and numbness. In conclusion, an ice pack applied for 10 minutes reduced the perineal temperature to the recommended levels for analgesia (10-15°C).

Planejamento da gestação entre puérperas de hospital público e privado - doi:10.5020/18061230.2008.p269

Purpose: To compare the attitudes of women at postpartum period, from a public (PuH) and a private hospital (PrH), regarding their pregnancy planning and to identify contraceptive methods that failed on use, in order to better direct the assistance at contraception. Methods: It was a descriptive study, held on two hospitals from the city of Sao Paulo. The data collection occurred in August, 2004, by means of a questionnaire applied to all women at postpartum period of each hospital (83 from PuH and 88 from PrU), comprising 171 interviewed. Statistical analysis was done by absolute frequencies and percentages. Results: Most of the interviewed women from PuH (69.9%; n=58) did not plan their pregnancy, while 83.0% (n=73) of those from PrH did so. The contraceptive methods that mostly caused failure were the pill (27.6%; n=16) and the condom (12.1%; n=7) at PuH; and the Ogino- Knaus method [rhythm method of contraception] (26.6%; n=4) and the pill (13.3%; n=2) at PrH. Conclusions: Pregnancy planning was done by most of the women from PrH; the same not occurring for women from PuH. The contraceptive pill and the condom, at PuH, and the rhythm method and the pill, at PrH, were the contraceptive methods that mostly failed. The accomplishment and disclosure of family planning programs for more deprived people is needed, as well as to favor them easy access to contraceptive methods.

Ensayo clínico comparando tres tipos de crioterapia en mujeres no embarazadas

O estudo teve como objetivo comparar tres modalidades de crioterapia em mulheres saudaveis e nao gravidas. Trata-se de um ensaio clinico randomizado, nao controlado, com 32 alunas do curso de graduacao de uma faculdade de enfermagem particular da cidade de Sao Paulo, divididas em tres grupos (gelo agua, gelo mole, gelo gel). Foram verificadas as temperaturas (axilar, coxa e das tres bolsas de gelo) entre zero e vinte minutos. As temperaturas das bolsas foram: gelo mole de 9°C negativos a 2°C, gelo agua de 0°C a 8°C e gelo gel de 11°C negativos a 2°C. Houve diferenca significativa entre as medias das temperaturas da coxa com 10 minutos (p=0,007), 15 minutos (p=0,003) e 20 minutos (p=0,005). O gel foi mais eficiente no resfriamento comparado aos outros dois metodos. As tres modalidades de crioterapia atingem a temperatura recomendada para analgesia e podem ser aplicadas em puerperas com dor perineal apos o parto normal.The objective of the present study was to compare three methods of cryotherapy in healthy non-pregnant women. This is a randomized controlled clinical trial that was conducted by 32 undergraduates of a private nursing college in the city of Sao Paulo, divided into three groups (iced water, soft ice, ice gel). The temperatures were verified (axillary, thigh, of the three ice packs) between zero and twenty minutes. The temperatures of the packs were the following: soft ice, from negative 9 degrees C to 2 degrees C; iced water, from 0 degrees C to 8 degrees C; and ice gel from negative 11 degrees C to 2 degrees C. There was a significant difference between the average thigh temperature values at 10 minutes (p = 0.007), 15 minutes (p = 0.003) and 20 minutes (p = 0.005). The gel was the most efficient cooling method. The three cryotherapy methods achieved the recommended temperature for analgesia and may be tested in women with perineal pain after childbirth.