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Ice Packing Versus Warm Sitz Baths for Post-hemorrhoidectomy Pain Management: A Randomized Controlled Trial
Pin-Chun Chen1, Yi-Kai Kao1, Po-Wen Yang1
1Division of Colon and Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan.
Diseases of the Colon and Rectum
|March 27, 2025
Summary
Ice packing significantly reduces post-hemorrhoidectomy pain and swelling compared to warm sitz baths. This method also promotes better wound healing and requires less opioid medication, offering a superior recovery option.
Area of Science:
- Colorectal Surgery
- Postoperative Care
- Pain Management
Background:
- Post-hemorrhoidectomy pain management is challenging.
- Warm sitz baths are a common but debated intervention.
Purpose of the Study:
- To compare the efficacy of ice packing versus warm sitz baths for post-hemorrhoidectomy pain and wound healing.
Main Methods:
- Randomized controlled trial with 166 patients undergoing Ferguson hemorrhoidectomy.
- Patients received either ice packing or warm sitz baths.
- Primary outcomes: pain (VAS) and swelling. Secondary outcomes: wound healing (REEDA score), analgesic consumption, adverse events.
Main Results:
- Ice packing group showed lower pain scores within 16 hours (p < 0.01).
- Reduced swelling at 24 hours (p = 0.03) and superior wound healing at 7 days (p = 0.02) in the ice packing group.
- Lower 24-hour morphine consumption (p < 0.01) in the ice packing group.
Conclusions:
- Ice packing is more effective than warm sitz baths for post-hemorrhoidectomy pain, edema, and wound healing.
- Ice packing has a comparable safety profile and reduces opioid requirements.
- Study limitations include single-center design and short follow-up.
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