228 Views

951 - Effects of Manual Lymphatic Drainage on Postoperative Pain: a Systematic Review and Meta-Analysis

Thursday, February 27, 2025

5:00 PM - 6:30 PM MST

Presenting Author(s)

HF

Holly Fullman, n/a

Medical Student
Rowan-Virtua School of Osteopathic Medicine
Chatham, New Jersey, United States

Co-Author(s)

HL

Han Jie Liu, n/a

Medical Student
Rowan-Virtua School of Osteopathic Medicine
Blackwood, New Jersey, United States
PS

Priyal Shah, n/a

Medical Student
Rowan-Virtua School of Osteopathic Medicine
Edison, New Jersey, United States
LP

Leonard Powell, DO

Doctor of Osteopathy
Rowan-Virtua School of Osteopathic Medicine
Stratford, New Jersey, United States

Objectives: Manual lymphatic drainage (MLD) is a nonpharmacological intervention which enhances lymphatic drainage from interstitial tissues without increasing capillary filtration. MLD is a potential treatment for postoperative lymphedema, autoimmune diseases, and other inflammatory conditions. There is conflicting evidence on the benefits of MLD in treating lymphedema, but there are no systematic reviews that address the effect of MLD on postoperative pain due to lymphedema.

Design: A systematic review and meta analysis was registered on PROSPERO and was performed following PRISMA guidelines. A search strategy was utilized to find randomized controlled trials (RCTs) studying the effects of MLD on postoperative pain compared to standard method of care or placebo. The following databases were used with no publication date restrictions: PubMed, Cochrane Library, Embase, and Scopus. Pain level was measured using the visual analog scale (VAS) or numeric rating scale (NRS) before the intervention and at hospital discharge. Six RCTs fit the inclusion criteria, yielding 284 participants.

Results: Both control (p=0.00, Cohen’s d = -1.32) and MLD (p=0.00, Cohen’s d = -2.34) showed significant difference in treating postoperative pain. Subgroup analysis revealed no significant differences between control and MLD groups (p=0.25). However, MLD may significantly clinically reduce postoperative pain compared to standard of care (Cohen’s d difference = 1.02).

Conclusions: MLD is a minimally invasive technique that may have clinical benefits on postoperative pain, leading to decreased burden of in-office visits or pain medication use. Due to its ease of use and minimal side effects, it can be performed within any socioeconomic population. A limitation to this study is the small sample size, requiring more high-quality RCTs on this subject. Future research should focus on establishing uniform guidelines for MLD application and exploring both its effects on length of hospital stay and long-term benefits in postoperative care.