Analgesia com laser terapêutico após tonsilectomia

Abstract

Objective:The postoperative period of a tonsillectomy is usually very painful, requiring the use of painrelieving drugs. The aim of this study was to evaluate the efficacy of low-level laser therapy in post-tonsillectomy pain control.Methods: 18 children aged 5 to 15 years undergoing adenotonsillectomy between June 2005 and October 2006 were randomized to receive either local application of therapeutic laser immediately after surgery and 24 hours postoperatively (n=9) or routine analgesic drug therapy, if necessary. Pain was assessed by visual analog scale scores, need for analgesics, and acceptance of diet during the postoperative period.Results: Patients undergoing laser applications had lower median pain scores and required less analgesic medication postoperatively than the control group. Acceptance of diet was similar in both groups.Conclusions: Preliminary results showed that low-level laser therapy is effective in the reduction of post-tonsillectomy pain, minimizing the need of analgesic medication in children and adolescents.Key-words: laser therapy; tonsillectomy; pain; child. RESUMOObjetivo: O pós-operatório da tonsilectomia é, em geral, bastante doloroso e os pacientes necessitam de analgésicos. Este estudo visou avaliar a eficácia da aplicação do laser terapêutico no controle da dor no pós-operatório de tonsilectomia.Métodos: 18 crianças de cinco a 15 anos de idade foram submetidas à adenotonsilectomia, no período de junho de 2005 a outubro de 2006, sendo randomizadas para receber aplicações de laser terapêutico na área cirúrgica imediatamente após o procedimento e 24 horas após a cirurgia (n=9) ou seguir a rotina, com analgesia farmacológica, se necessário. A avaliação da dor foi realizada por escala analógica de dor, pela necessidade de analgésicos e pela aceitação da dieta no pós-operatório.Resultados: Os pacientes submetidos à aplicação do laser apresentaram medianas das notas da escala de avaliação da dor menores e utilizaram menos analgésicos no pós-operatório em comparação aos pacientes controles. A aceitação da dieta nos dois grupos não foi diferente.Conclusões: Os resultados preliminares mostraram que o laser terapêutico foi eficaz na diminuição da dor e na redução de uso de analgésicos no pós-operatório de tonsilectomias em crianças e adolescentes.

The Effects of Photobiomodulation Therapy on Post-Surgical Pain

“…The results of 8 other studies that were studied in this review showed that LLLT was effective in reducing postoperative pain in patients with breast augmentation surgery, 26 inguinal hernia surgery, 27 tonsillectomy, 28,31 episiotomies, 29 tibial fracture surgery 24 and coronary artery bypass surgery. 32,33 In addition, the laser can reduce the use of pain relief medication, thus protecting the patient from the complications of these drugs.…”

“…The effect size was only calculated in 4 papers, 24,25,29,31 and in other articles due to the absence of SD or VAS, was not calculated. [26][27][28]30,32,33 As well, in Santos et al 29 VAS measurement was performed twice; more than 2 hours after surgery, and after 40-48 hours after surgery. Therefore, one of these measurements was used to determine the treatment effect size.…”

Photobiomodulation for Lowering Pain after Tonsillectomy: Low Efficacy and a Possible Unexpected Adverse Effect

“…A meta-analysis conducted in 2019 indicates that PBM can be effective in modulating pain and inflammation following surgery, with the most efficacious results for postoperative pain after tonsillectomy [23]. Additionally, considering two previous studies that indicated a beneficial effect on pain modulation in tonsillectomy in adult [10] and pediatric populations [9], this clinical trial was conceived and proposed to the ethical committee. The PBM protocol proposed in this study differs from both studies cited above, in using 3 different wavelengths instead of 1, either 980 nm for adults or 685 nm for children, and a higher fluency (12 J/cm 2 in our protocol compared with 4 J/cm 2 ).…”

“…A previous study evaluated PBM efficacy in managing pain sensation after pediatric tonsillectomy and it demonstrated that in 9 patients treated with laser; nociception was significantly lower requiring fewer analgesic drugs in respect to untreated children (laser wavelength 685 nm, spot size 2 mm 2 , and fluence 4 J/cm 2 ) [9]. A more recent study [10] demonstrated, in 60 adults undergoing tonsillectomy, a significant reduction in pain sensation and in administration of analgesic drugs (laser wavelength 980 nm, spot size 2 mm 2 , and fluence 4 J/cm 2 ).…”

Influência Da Laserterapia Na Dor E Qualidade De Vida Em Mulheres Com Fibromialgia

“…O efeito analgésico do laser é proveniente da inibição da formação do potencial de ação no nervo periférico, afetando a condução do estímulo nervoso, diminuindo ou interrompendo a transmissão dos impulsos evocados dos nociceptores para a medula espinhal (NEIVA et al, 2010).…”