بررسي ويژگي هاي دو روش سرما درماني غيردارويي بر ميزان درد ناشي

Survey the characteristics of two methods of non-pharmacological cryotherapy on perineal pain level due to episiotomy

زمينه و هدف: سرما درماني، ساده ترين و قديمي ترين شكل درماني در آسيب هاي بافت نرم مي باشد. هدف از انجام اين مطالعه سنجش كارايي دو نوع وسيله خنك كننده بسته يخ و نوار حاوي ژل خنك كننده بر ميزان درد ناشي از اپي زيوتومي مي باشد. مواد و روش ها: در اين مطالعه كارآزمايي باليني 81 زن سالم نخست زا با زايمان طبيعي همراه با اپي زيوتومي در بيمارستان ام البنين مشهد در سال 1385 در دو گروه سرمادرماني (41 نفر در گروه نوار حاوي ژل خنك كننده و40 نفر در گروه بسته يخ) قرار گرفتند. سطح درد پرينه، سردي وسيله خنك كننده در ده دقيقه اوّل و طول مدّت اثر ضّد دردي وسيله طي روزهاي اوّل، دوّم، پنجم و دهم ارزيابي شد. پرسشنامه فقط در اولين اندازه گيري مد نظر قرار گرفت. همبستگي بين تك تك سوال ها دو بار محاسبه و حداقل توافق 60/0r= بود. داده ها در نرم افزار16 SPSS با آزمون كاي دو و آزمون دقيق فيشر تجزيه و تحليل شد. يافته ها: بين دو گروه (بسته يخ و نوار حاوي ژل خنك كننده) از نظر سطح درد طي استفاده از وسيله خنك كننده در روز دوّم (001/0 = P)، روز پنجم (02/0=P ) و روز دهم (005/0= P) تفاوت معني داري وجود داشت، اما دو گروه از نظر سردي ده دقيقه اوّل وسيله خنك كننده و طول مدّت اثر ضّد دردي وسيله، در روزهاي اوّل، دوّم، پنجم و دهم تفاوت آماري نداشتند. نتيجه گيري: با توجه به ويژگي هاي وسيله خنك كننده، كاهش نياز به مصرف تعداد مسكن خوراكي و رضايت مندي واحدهاي پژوهش نوار حاوي ژل وسيله اي مناسب تر از بسته يخ جهت كاهش درد پرينه ناشي از اپي زيوتومي مي باشد.

Background and Objective: Cryotherapy as ais one of the local therapy ies which is the simplest and oldest therapeutic modality method in the treatment of damaged soft tissue. The aim of this study was to assess the efficiency of two methods of cryotherapy cryotherapynon-pharmacological , the ice pack and Ccooling gel pad cryotherapy on perineal perineal pain level due to episiotomy. Materials and Method: This randomized controlled trial study was conducted on 81 healthy primiparous women with normal vaginal delivery and episiotomy in Ommul- Banin hospital of Mashhad in 13852006. They were assigned intoallocated to the two groups of cryotherapycryotherapy cold therapy (41 in cooling gel pad =41group, and 40 in ice pack=40 group). The level of perineal pain, the coldness of cooling devices were evaluated during the first 10 minutes and also, duration of analgesia effect were evaluated at 1, 2, 5, 10 days after intervention. The validity and reliability of the questionnaire were measured through content validity and retestwas used in the first measurement. It was considered only at the first measurements. The correlation between each question measured twice, and the least agreement was r=0/600.60. The data were analyzed with SPSS 16 16and , chi Chi square and fisher’s exact test. Results: There was a statistically significant difference between the two groups (cooling gel pad, ice pack) considering to the pain level on second day (P=0/0010.001), fifth day (P=0/020.02), tenth day (P=0/0050.005), during the use of cooling device. But there was no significant difference between the two groups regard to coldness in the first 10 minutes and duration of analgesia effect of cooling device on in first, second, fifth and tenth day. Conclusion: In terms of the properties of cooling device such as reduction the need of taking of oral pain releifanalgesia drug and satisfaction of patients, so cooling gel pad is better than ice pack on tofor reduce reducing episiotomy pain. Keywords: Cryotherapy, perineal pain, episiotomy