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Muaddi 2021
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Muaddi H, Lillie E, Silva S, Cross JL, Ladha K, Choi S, Mocon A, Karanicolas P. The Effect of Cryotherapy Application on Postoperative Pain: A Systematic Review and Meta-analysis. Ann Surg. 2023 Feb 1;277(2):e257-e265.
Design: Systematic Review and Meta-Analysis Methods: MEDLINE, EMBASE and Cochrane databases were searched for RCTs that examined postoperative application of cryotherapy over surgical incisions in adults compared to no cryotherapy were eligible. Data were synthesized using random effects meta-analyses. Outcomes included: Postoperative pain, opioid use, Hospital length of stay (LOS), Surgical site infection (SSI). Results:
Key message: Cryotherapy is a pragmatic, non-costly intervention that reduces postoperative pain and opioid consumption but does not affect surgical site infection rate or hospital length of stay.
• Fifty-one RCTs (N = 3425 patients) were included.
• With moderate certainty evidence, patients treated with cryotherapy experienced a reduction in pain on postoperative day 1 (standardized mean differences -0.50, 95% CI -0.71 to -0.29, I2= 74%) and day 2 (standardized mean differences -0.63, 95% CI -0.91 to -0.35, I2= 83%) relative to without cryotherapy application. • With moderate certainty of evidence, cryotherapy reduces opioid consumption in morphine milliequivalents and morphine milliequivalents/kg, (mean differences -7.43, 95% CI -12.42, -2.44, I2= 96%) and (mean differences -0.89, 95% CI -1.45, -0.33, I2= 99%), respectively. • With low certainty evidence, cryotherapy does not affect hospital LOS or rate of SSI.
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