A randomised controlled trial of the effects of cryotherapy on pain, eyelid oedema and facial ecchymosis after craniotomy

Abstract

Aim. To identify the effects of cryotherapy on patient discomfort following craniotomy. Background. Following craniotomy, many patients suffer from unexpected discomfort, including pain, eyelid oedema and ecchymosis. Cryotherapy is regarded as a safe method for managing these postcraniotomy problems. Design. Randomised controlled trial. Methods. A total of 97 Korean patients who underwent elective supratentorial craniotomy were randomly assigned to a cryotherapy or a control group. In the cryotherapy group, ice bags were applied to surgical wounds, and cold gel packs were applied to periorbital areas, for 20 minutes per hour, beginning three hours postoperatively and for three days thereafter. The level of patient pain was measured using the visual analogue scale while the eyelid oedema was measured using the Kara & Gokalan's scale. Ecchymosis was also classified according to its extent. Results. The level of pain three hours after craniotomy was similar in the cryotherapy and control groups (57AE9 vs. 58AE7). Three days after surgery, pain had significantly decreased in the cryotherapy group (p = 0AE021). After adjusting diagnosis by analysis of covariance (ANCOVA) (ANCOVA), pain score did not differ significantly between the two groups. The mean eyelid oedema scores were lower in the cryotherapy group than in the control group (0AE59 vs. 2AE29, p < 0AE001), with ANCOVA ANCOVA showing that cryotherapy had a significant effect on eyelid oedema (p < 0AE001). Pain (p = 0AE047) and eyelid oedema (p < 0AE001) in the cryotherapy group were significantly decreased over time. Ecchymosis were significantly less frequent in the cryotherapy (11/48, 22AE9%) than in the control (26/49, 53AE1%) group (p = 0AE003). Logistic regression analysis showed that cryotherapy affected ecchymosis (p = 0AE001). Conclusion. These results indicate that cryotherapy can control pain, eyelid oedema and facial ecchymosis after craniotomy. Relevance to clinical practice. Cryotherapy, which is both convenient and cost-effective, can be used to prevent postoperative discomforts in a clinical setting.

The Effect of Eyelid Cooling on Pain, Edema, Erythema, and Hematoma after Upper Blepharoplasty

“…3 The neural effects are also thought to be mediated through vasoconstriction, leading to decreased edema, decreased release of localized pain mediators, and a slowing of nerve conduction velocity of peripheral nerve fibers. 8 Our study of upper blepharoplasty shows no treatment effect of cooling on edema, erythema, and hematoma. In gynecologic patients undergoing exploratory laparotomy, cold ice pack application did not improve postoperative pain, 5 nor did cooling with facial ice packs improve postoperative pain, facial swelling, or trismus after third molar surgery.…”

Comparative Study on Bruise Reduction Treatments After Bruise Induction Using the Pulsed Dye Laser

“…Results indicated no appreciable difference in the intensity of ecchymosis between the postoperative hypothermia group and the control group, although significantly less ecchymosis was reported in the group receiving operative and postoperative hypothermia . Similar results by Shin and colleagues supporting early application of a cold compress was found in postcraniotomy patients . These findings suggest that the timing and duration of cold compress therapy is related to its effectiveness.…”

“…In our study, therapy was initiated immediately after bruise induction, and the treatment period lasted 10 minutes. Shehadi treated participants throughout surgery and continuously during waking hours for 2 days, and Shin and colleagues treated patients for 20 minutes per waking hour for 3 days after surgery . In Shehadi's study, there was no difference from control in bruise reduction in participants who received only postoperative cryotherapy, whereas participants in the study by Shin and colleagues, who underwent similar treatment, showed significantly less ecchymosis.…”

Interferência e características do edema periorbital no exame pupilar após craniotomia

“…On the one hand, this procedure presents a risk of infectious complications and an increase in surgical costs. On the other hand, the eyelid edema harms patients' vision, (1) causes pain, hampers eye hygiene and sometimes results in restlessness.…”

“…(1) The incidence of subgaleal collection can vary from 7% to 33%, and periorbital edema from 2.8% to 100%. (2,3) During the immediate postoperative period of craniotomy, patients can have neurosurgery complications, such as hematomas and cerebral edema as a result of surgical trauma.…”