Perineal Cold Gel Pad Versus Oral Analgesic to Relief Episiotomy Wound Pain

Tuesday, 8 July 2008: 1:35 PM
Thangaraju Punasundri, RN , W53A O&g, Singapore General Hospital, Singapore, Singapore

Learning Objective 1: understand the effectiveness of topical application versus oral medication in the relief of perineal wound pain.

Learning Objective 2: understand that early reduction in pain helps the postnatal mothers to ambulate,manage and breastfeed their babies early.



The primary cause of perineal pain is the episiotomy or tearing of the perineum during vaginal delivery. Perineal pain in the early post partum period has been reported to be one of the most common causes of maternal morbidity. It also impairs a mother's ability and willingness to care for the newborn. Currently, the patient is prescribed a standard regime of tab paracetamol three times a day for pain relief. This study was undertaken to compare the effectiveness of perineal cold gel pad versus oral analgesics in post partum perineal pain relief.


220 patients who delivered their first or second baby by normal vaginal delivery or assisted vaginal delivery with an episiotomy done were selected and randomized into either a control or experimental group. The control group was given oral analgesics while the experimental group was given one packet of 4 perineal cold gel pads post delivery. Assessment and pain score rating was done by the nurse at intervals of 3, 6, 12, and 24 hrs. These ratings were record in the questionnaire provided.


Pain score for the cold gel group was statistically significant, p< 002 after 3 hours of pain relief to p< 000 at 6 hrs. 19.1% to 27 % of patients in the oral analgesic group experienced no pain compared to 26.4% to 49.1 % in the cold gel pad group. Due to reduction in pain, patients in the cold gel pad were able to ambulate, manage and breast feed their babies early. A total of 97.3% of patients were satisfied with the cold gel pads for its effectiveness in absorbing the lochia.


The study showed that the use of the cold gel pads as an alternative method of pain relief was as effective in reducing perineal pain as oral analgesics.