Topical ice has been shown to reduce pain scores and opioid use in adults with midline abdominal incisions. This study was designed to evaluate the efficacy of a cold therapy system in children following laparoscopic appendectomy. Patients 7 years and older who underwent laparoscopic appendectomy at our institution from December 2021–September 2022 were eligible. Patients were randomized to standard pain therapy (control) or standard plus cold therapy (treatment) utilizing a modified ice machine system with cool abdominal pad postoperatively. Pain scores on the first 3 postoperative days (PODs), postoperative narcotic consumption, and patient satisfaction were analyzed. Fifty-eight patients were randomized, 29 to each group. Average survey response rate was 74% in control and 89% in treatment patients. There was no significant difference in median pain scores or narcotic use between groups. Cold therapy contributed to subjective pain improvement in 71%, 74%, and 50% of respondents on PODs 1, 2, and 3 respectively. A majority of patients reported cold therapy to be a helpful adjunct in pain control after appendectomy, though it did not reduce postoperative pain scores or narcotic use in our cohort - likely due to this population's naturally expedient recovery and low baseline narcotic requirement. Randomized Controlled Trial. Level I.

中文翻译：

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冷疗法控制小儿阑尾切除术患者的疼痛：一项随机对照试验

局部冰敷已被证明可以减少腹部中线切口成人的疼痛评分和阿片类药物的使用。本研究旨在评估冷疗系统对腹腔镜阑尾切除术后儿童的疗效。 2021 年 12 月至 2022 年 9 月期间在我们机构接受腹腔镜阑尾切除术的 7 岁及以上患者符合资格。术后，患者被随机分配接受标准疼痛治疗（对照）或标准加冷疗（治疗），使用改良制冰机系统和冷腹垫。分析术后前 3 天的疼痛评分 (POD)、术后麻醉剂消耗量和患者满意度。 58 名患者被随机分配，每组 29 名。对照组的平均调查响应率为 74%，治疗患者的平均调查响应率为 89%。各组之间的中位疼痛评分或麻醉剂使用没有显着差异。冷疗对 POD 1、2 和 3 的受访者主观疼痛改善分别有 71%、74% 和 50%。大多数患者报告冷疗是阑尾切除术后疼痛控制的有效辅助手段，尽管它并没有减少我们队列中的术后疼痛评分或麻醉剂使用 - 可能是由于该人群自然方便的恢复和较低的基线麻醉剂需求。随机对照试验。一级。