Cold Therapy Following Laparoscopic Cholecystectomy

Patients in the study group will receive cold therapy using an ice pack for 20 minutes every hour, starting from the first hour after laparoscopic cholecystectomy and continuing for the first 8 hours. Once the patient regains consciousness after the surgical procedure, they will be informed, and the Demographic and Clinical Characteristics Form will be completed during the first hour; the patient will then be assessed according to the VAS and Cold Therapy Chart. Since skin temperature must drop below 13.6 °C for cold therapy to have a local analgesic effect, the patient's skin temperature will be measured every five minutes during the cold therapy session, and the application will be discontinued when it reaches 13.6 °C. Following cold application, the investigator will re-evaluate patients using the VAS and the Cold Application Chart at 1, 8, and 24 hours.

Patients will be asked to complete the "Richard-Campbell Sleep Scale" and the (QoR-15) after surgery.

Patients in the study group will receive cold therapy using an ice pack for 20 minutes every hour, starting from the first hour after laparoscopic cholecystectomy and continuing for the first 8 hours. Once the patient regains consciousness after the surgical procedure, they will be informed, and the Demographic and Clinical Characteristics Form will be completed during the first hour; the patient will then be assessed according to the VAS and Cold Therapy Chart. Since skin temperature must drop below 13.6 °C for cold therapy to have a local analgesic effect, the patient's skin temperature will be measured every five minutes during the cold therapy session, and the application will be discontinued when it reaches 13.6 °C. Following cold application, the investigator will re-evaluate patients using the VAS and the Cold Application Chart at 1, 8, and 24 hours. Patients will be asked to complete the "Richard-Campbell Sleep Scale" and the (QoR-15) after surgery.

Patients in the control group, however, will receive the clinic's routine treatment and nursing care without any additional interventions. At the clinic where the study will be conducted, when patients return to their rooms following laparoscopic cholecystectomy, they are administered the analgesics prescribed by the physician [paracetamol (1000 mg/100 ml) and/or ketavel (50 mg/2 ml) and/or pethidine hydrochloride (100 mg/2 ml)] are administered, and the patient is placed on strict bed rest for six hours. After six hours, patients are encouraged to walk, and oral intake is initiated. At the clinic, no non-pharmacological methods are used to reduce pain in patients following laparoscopic cholecystectomy.

Visual Analog Scale (VAS): This form examines patients' demographic and clinical characteristics; it includes information on the patient's age, gender, educational status, and whether analgesics were administered following laparoscopic cholecystectomy, as well as the type and dosage if administered.

Richard-Campbell Sleep Scale: Developed by Richards in 1987, this sleep scale consists of six items that assess the depth of nighttime sleep, the time taken to fall asleep, the frequency of awakenings, the duration of wakefulness after waking, sleep quality, and the noise level in the environment. Özlü and Özer conducted a validity and reliability study of the scale in Turkey in 2015. Each item is rated on a scale from 0 to 100 using the visual analog scale technique. On the scale, a score between "0 and 25" indicates very poor sleep, while a score between "76 and 100" indicates very good sleep. The total score is calculated based on the first five items, and the sixth item-which assesses ambient noise levels-is excluded from the total score calculation. Patients' sleep quality improves as their score on the scale increases. While the Cronbach's α value of the original scale is 0.82, that of the Turkish version is 0.91.

Quality of Recovery-15 (QoR-15): The QoR-15 was developed in 2013 as a revised and abbreviated version of the QoR-40 to assess the quality of recovery following surgery and anesthesia. This unidimensional scale is designed to assess patients' quality of recovery and well-being in the early postoperative period. It consists of a 15-item questionnaire that evaluates the patient's physical comfort, physical independence, emotional state, psychological support, and pain status. For each question on the QoR-15, the patient is asked to rate their level of recovery on a scale from 0 to 10. Once all responses are collected, a total score ranging from 0 to 150 is calculated. A total score between 136 and 150 indicates excellent recovery; between 122 and 135, good recovery; between 90 and 121, moderate recovery; and between 0 and 89, poor recovery. Validity and reliability studies of the Turkish version of the QoR-15 were conducted by Selvi et al., and Cronbach's α was found to be 0.928.

Cold Application Chart: Data regarding the timing of cold application to the trocar incision in the abdominal region, skin surface temperature before and after cold application, and the pre- and post-application temperatures of the cold application material (ice pack) will be recorded.