The effect of cold application on episiotomy pain: A systematic review and meta-analysis

Abstract

Aims and Objectives: To evaluate the effectiveness of cold application methods in reducing postpartum episiotomy pain. Background: Many women suffer from pain after giving birth due to an episiotomy. This prolonged pain affects their daily lives as they recover. Various methods can help alleviate this pain; however, the effects of cold application specifically are still under discussion. Design: Systematic review and meta-analysis were used. Methods: In this review, we investigated studies from the CINAHL, PubMed, Google Scholar and Science Direct databases that met PICOS inclusion criteria. We also assessed the studies' methodological quality with the JADAD and JBI checklists. This study was performed based on the Guidelines of Systematic Reporting of Examination presented in the PRISMA checklist (Appendix S1). The search protocol has been registered at the PROSPERO International Prospective Register of Systematic Reviews. Results: A total of seven published studies including 700 total participants were included in this review. Various cold application methods (cold gel pack/pad, crushed ice gel pad, ice pack) significantly reduced the pain after an episiotomy. Ice packs in particular did not significantly differ from lavender oil and acupressure in reducing pain after an episiotomy. Conclusions: Cold application methods can be an effective, non-pharmacological midwifery and nursing intervention to reduce pain after an episiotomy. Relevance to clinical practice: The use of cold application methods to reduce pain after episiotomy may reduce the need for pharmacological medication in women due to the reduction in pain in the perineum. © 2021 John Wiley & Sons Ltd.