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Effects of Localized Cold Therapy on Pain in Postoperative Spinal Fusion Patients: A Randomized Control Trial

Quinlan, Patricia; Davis, Jack; Fields, Kara; Madamba, Pia; Colman, Lisa; Tinca, Daniela; Cannon Drake, Regina

doi: 10.1097/NOR.0000000000000382
Original Articles

BACKGROUND: Cold therapy used in the sports medicine settings has been found to be effective in reducing postoperative pain; however, there are limited studies that examine the effect of cold therapy on postoperative pain in patients with posterior lumbar spinal fusion.

PURPOSE: The purpose of this study was to determine the effects of cold on postoperative spine pain and add to the body of knowledge specific to practical application of cold therapy in the spine surgery setting.

METHODS: Researchers used a two-group randomized control design to evaluate the effects of local cold therapy on postoperative pain and analgesia use after lumbar spinal fusion surgery. The primary outcome was postoperative pain. Secondary outcomes included analgesia use and perceived benefit of cold therapy.

RESULTS: The intervention (cold) group had a marginally greater reduction in mean Numerical Rating Scale score across all 12 pain checks (M ± SD = −1.1 ± 0.8 points reduction vs. −1.0 ± 0.8 points reduction, p = .589). On average, the intervention group used less morphine equivalents (M ± SD = 12.6 ± 31.5 vs. 23.7 ± 40.0) than the control group across pain checks seven to 12 (p = .042).

CONCLUSIONS: This study provides additional evidence to support the use of cold therapy as an adjuvant pain management strategy to optimize pain control and reduce opioid consumption following spine fusion surgical procedures.

Patricia Quinlan, PhD, MPA, RN, CPHQ, AVP Nursing Excellence, Department of Nursing, Hospital for Special Surgery, New York, NY.

Jack Davis, MSN, RN, ONC, Manager, Patient Education Programs and Research, Department of Nursing, Hospital for Special Surgery, New York, NY.

Kara Fields, MS, Statistical Analyst, Healthcare Research Institute, Hospital for Special Surgery, New York, NY.

Pia Madamba, BSN, RN, ONC, Patient Care Director, Department of Nursing, Hospital for Special Surgery, New York, NY.

Lisa Colman, RN, ONC, Clinical Nurse, Department of Nursing, Hospital for Special Surgery, New York, NY.

Daniela Tinca, BSN, RN, ONC, Clinical Nurse, Department of Nursing, Hospital for Special Surgery, New York, NY.

Regina Cannon Drake, MA, RN, ONC, Patient Educator, Department of Nursing, Hospital for Special Surgery, New York, NY.

The authors have disclosed no conflicts of interest.

© 2017 National Association of Orthopaedic Nurses