Abdominal Ice Application After Cesarean Section (ICE-CS)

Effect of Intermittent Abdominal Ice Application on Postoperative Pain and Opioid Consumption After Elective Cesarean Section: A Randomized Controlled Study

Cesarean section is one of the most commonly performed surgical procedures worldwide, and effective postoperative pain control is important for maternal recovery and patient comfort. This randomized controlled study evaluated whether intermittent abdominal ice application after elective cesarean section could reduce postoperative pain and opioid consumption. Eighty patients undergoing cesarean delivery under spinal anesthesia were randomly assigned to receive either intermittent abdominal ice application in addition to standard multimodal analgesia or standard postoperative care alone. Postoperative pain scores, opioid consumption, patient satisfaction, and postoperative recovery outcomes were evaluated during the first 24 postoperative hours.

Study Overview

• Status: Completed
• Conditions: Postoperative Pain; Cesarean Section; Postoperative Pain After Cesarean Section
• Intervention / Treatment: Procedure: Abdominal Ice Application; Other: Standard Postoperative Care

Detailed Description

This prospective randomized controlled study was conducted to evaluate the effects of intermittent abdominal ice application on postoperative pain and opioid consumption after elective cesarean section. Eighty patients undergoing elective cesarean delivery under spinal anesthesia were randomly assigned in a 1:1 ratio to either an ice application group or a control group. Patients in the intervention group received intermittent abdominal ice application over the surgical incision area for 20-minute sessions every 2 hours during the first postoperative 12 hours in addition to standard multimodal analgesia. The control group received standard postoperative multimodal analgesia alone.

Postoperative pain intensity was assessed using the Numeric Rating Scale (NRS) at predefined postoperative time points during the first 24 hours. Secondary outcomes included tramadol consumption, morphine consumption, patient satisfaction, first analgesic request time, total postoperative pain burden assessed using area under the curve (AUC) analysis, and responder analysis. The study was approved by the local ethics committee, and written informed consent was obtained from all participants before enrollment.

• Study Type: Interventional
• Enrollment (Actual): 80
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Niğde, Turkey (Türkiye), 51200
    • Niğde Ömer Halisdemir University Training and Research Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Women aged 18-45 years American Society of Anesthesiologists (ASA) physical status I-II Singleton term pregnancy Elective cesarean section performed under spinal anesthesia Ability to understand and use the Numeric Rating Scale (NRS) Written informed consent obtained before participation

Exclusion Criteria:

• Emergency cesarean section Chronic pain disorders or chronic opioid use Allergy or contraindication to study medications Infection or skin lesion at the ice application site Psychiatric or neurological disorders affecting pain assessment Conversion to general anesthesia Refusal to participate in the study

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Ice Group; Participants received intermittent abdominal ice application over the surgical incision area for 20-minute sessions every 2 hours during the first postoperative 12 hours in addition to standard postoperative multimodal analgesia.	Procedure: Abdominal Ice Application; Intermittent abdominal ice application over the surgical incision area for 20-minute sessions every 2 hours during the first postoperative 12 hours.; Other Names: Cryotherapy; Cold Gel Pack Application
Active Comparator: Control Group; Participants received standard postoperative multimodal analgesia without abdominal ice application.	Other: Standard Postoperative Care; Standard postoperative multimodal analgesia without abdominal ice application.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative Pain Intensity Assessed Using the Numeric Rating Scale (NRS)	Postoperative pain intensity was evaluated using the Numeric Rating Scale (NRS; 0-10) at predefined postoperative time points during the first 24 postoperative hours.	During the first 24 postoperative hours

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative Tramadol Consumption	Total postoperative tramadol consumption during the first 24 postoperative hours.	24 postoperative hours
Postoperative Morphine Consumption	Total postoperative morphine consumption during the first 24 postoperative hours.	24 postoperative hours
Patient Satisfaction Scores	Patient satisfaction with postoperative pain management assessed during the postoperative period.	24 postoperative hours

Collaborators and Investigators

• Sponsor: Nigde Omer Halisdemir University

Study record dates

Study Major Dates

• Study Start (Actual): May 1, 2022
• Primary Completion (Actual): October 1, 2022
• Study Completion (Actual): October 1, 2022

Study Registration Dates

• First Submitted: May 29, 2026
• First Submitted That Met QC Criteria: May 29, 2026
• First Posted (Actual): June 4, 2026

Study Record Updates

• Last Update Posted (Actual): June 4, 2026
• Last Update Submitted That Met QC Criteria: May 29, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Postoperative Pain; Randomized Controlled Trial; Cesarean Section; Cryotherapy; Spinal Anesthesia; Multimodal Analgesia; Opioid-Sparing Analgesia; Abdominal Ice Application
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Pain, Postoperative; Therapeutics; Cryotherapy
• Other Study ID Numbers: NOHU-CS-ICE-2022; 2022/33 (Registry Identifier: Niğde Ömer Halisdemir University Non-Interventional Clinical Research Ethics Committee)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified individual participant data underlying the results reported in this study will be available from the corresponding author upon reasonable request following publication.
• IPD Sharing Time Frame: Upon publication of the study
• IPD Sharing Access Criteria: De-identified individual participant data (IPD) and study protocol-related documents will be available to researchers who provide a methodologically sound proposal. Access will be granted for academic research purposes only after publication of the study. Requests should be directed to the corresponding author. Data will be shared in a secure electronic format after approval of the proposal and signing of a data-sharing agreement.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No