A randomised clinical trial of the effect of low-level laser therapy for perineal pain and healing after episiotomy: a pilot study
Santos Jde O, Oliveira SM, Nobre MR, Aranha AC, Alvarenga MB
Midwifery · 25 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- Fundação de Amparo à Pesquisa do Estado de São Paulo
- Gobierno
- Fundação de Amparo à Pesquisa do Estado de São Paulo
Según 2 financiadores declarados.
Publicación
- Publicado
- 2012-10-01 · Midwifery · vol. 28 · número 5 · págs. e653–e659
- Editorial
- Elsevier BV
- Citado
- 40 citas · más que el 83% de estudios similares · 1.8× el promedio de su campo
- Referencias
- 35 trabajos
- Acceso
- De pago
- Áreas de investigación
- Laser Applications in Dentistry and Medicine · Pregnancy-related medical research · Maternal and Perinatal Health Interventions
- Palabras clave
- low-level laser therapy, perineal pain, mediolateral episiotomy, postpartum women, diode laser, placebo effect, REEDA scale, perineal wound healing, childbirth complications, obstetric care
- MeSH
- perineum, humans, puerperal disorders, pain measurement, treatment outcome, episiotomy, pilot projects, wound healing, adult, brazil, female, young adult, low-level light therapy, postoperative pain
5 autores
- Jaqueline de Oliveira Santos🇧🇷 · autor de correspondenciaUniversidade Paulista
- Sônia Maria Junqueira Vasconcellos de Oliveira🇧🇷Universidade de São Paulo
- Moacyr Roberto Cucê Nobre🇧🇷Universidade de São Paulo; Instituto do Coração - HCFMUSP
- Ana Cecília Corrêa Aranha🇧🇷Universidade de São Paulo
- Marina Barreto Alvarenga🇧🇷Universidade de São Paulo
Resumen
El texto original del estudio, en el idioma en que se publicó.
Objective
to evaluate the effects of low-level laser therapy for perineal pain and healing after episiotomy.
Design
a double-blind, randomised, controlled clinical trial comparing perineal pain scores and episiotomy healing in women treated with low-level laser therapy (LLLT) and with the simulation of the treatment.
Setting
the study was conducted in the Birth Centre and rooming-in units of Amparo Maternal, a maternity service located in the city of São Paulo, Brazil.
Participants
fifty-two postpartum women who had had mediolateral episiotomies during their first normal delivery were randomly divided into two groups of 26: an experimental group and a control group.
Intervention
in the experimental group, the women were treated with LLLT. Irradiation was applied at three points directly on the episiotomy after the suture and in three postpartum sessions: up to 2 hrs postpartum, between 20 and 24 hrs postpartum and between 40 and 48 hrs postpartum. The LLLT was performed with diode laser, with a wavelength of 660 nm (red light), spot size of 0.04 cm(2), energy density of 3.8 J/cm(2), radiant power of 15 mW and 10s per point, which resulted in an energy of 0.15 J per point and a total energy of 0.45 J per session. The control group participants also underwent three treatment sessions, but without the emission of radiation (simulation group), to assess the possible effects of placebo treatment.
Main outcomes
perineal pain scores, rated on a scale from 0 to 10, were evaluated before and immediately after the irradiation in the three sessions. The healing process was assessed using the REEDA scale (Redness, Edema, Echymosis, Discharge Aproximation) before each laser therapy session and 15 and 20 days after the women's discharge.
Findings
comparing the pain scores before and after the LLLT sessions, the experimental group presented a significant within-group reduction in mean pain scores after the second and third sessions (p=0.003 and p<0.001, respectively), and the control group showed a significant reduction after the first treatment simulation (p=0.043). However, the comparison of the perineal pain scores between the experimental and control groups indicated no statistical difference at any of the evaluated time points. There was no significant difference in perineal healing scores between the groups. All postpartum women approved of the low-level laser therapy.
Conclusions
this pilot study showed that LLLT did not accelerate episiotomy healing. Although there was a reduction in perineal pain mean scores in the experimental group, we cannot conclude that the laser relieved perineal pain. This study led to the suggestion of a new research proposal involving another irradiation protocol to evaluate LLLT's effect on perineal pain relief.
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