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Sammons T, Shanks S. Efficacy of red low-level laser for postoperative pain management: A review of literature. J Perioper Pract 2023; 33:350-357. [PMID: 36394302 DOI: 10.1177/17504589221124757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Many patients who undergo surgical procedures experience acute postoperative pain, with less than half receiving adequate pain relief. Recent advancements in postoperative pain management include the market clearance by the US Food and Drug Administration for the utilisation of red low-level laser therapy in providing postoperative pain relief. The Food and Drug Administration market clearance was based on clinical data from randomised controlled trials that supported the safety and effectiveness of visible red laser therapy across various surgical procedures. This review of literature aims to evaluate the mechanisms of action, the dose-response curves and clinical outcomes of red low-level laser for postoperative pain management. A literature search was limited to randomised controlled trials that evaluated the use of red low-level laser therapy on postoperative pain. The results from the literature search found that seven studies met the search qualifications. The literature review findings demonstrated that red low-level laser therapy is a safe and effective treatment alternative for postoperative pain management. In addition to postoperative pain reduction, the findings of the literature revealed that red low-level laser therapy may promote healing and reduce the consumption of postoperative prescription analgesic drugs.
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Kazemikhoo N, Kyavar M, Razzaghi Z, Ansari F, Maleki M, Ghavidel AA, Gholampour M, Ghaffarinejad MH. Effects of intravenous and transdermal photobiomodulation on the postoperative complications of coronary artery bypass grafting surgery: a randomized, controlled clinical trial. Lasers Med Sci 2021; 36:1891-1896. [PMID: 33398614 DOI: 10.1007/s10103-020-03236-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 12/22/2020] [Indexed: 10/22/2022]
Abstract
Although coronary artery bypass graft (CABG) surgery is one of the most worldwide commonly performed cardiac surgeries to enhance myocardial perfusion in high-grade myocardial occlusion, it remains a high-risk procedure. Photobiomodulation (PBM) is one of the methods which have been shown to have positive effects on the healing process after CABG and postoperative complications. The aim of this study was to evaluate the efficacy of PBM in patients who underwent a coronary artery bypass graft (CABG). Ths study was conducted with 192 volunteers who electively submitted to CABG. The volunteers were randomly allocated into two groups: laser-treated (transdermal: 980 nm, 200 mW, continuous, average energy fluency of 6 J/cm2 and intravenous: 405 nm, 1.5 mW, continuous for 30 min) and standard treatment and control group (standard treatment only). Intravenous laser was illuminated the day before the surgery, immediately after transferring the patient to CCU post-operation and IV laser in addition to transdermal laser was applied every day after surgery for 6 days. A total of 170 out of 192 participants completed the study, 82 (48.2%) in the PBM group and 88 (51.8%) in the control group. Level of LDH and CPK was significantly lower in the PBM group (P < 0.05) in the 4th day postoperatively. The PBM group also showed significantly lower post-surgery complications, including pericardial effusion, ejection fraction, pathologic ST changes, pathologic Q, rehospitalization, heart failure, and mediastinitis (P < 0.05). Likewise, the VAS pain score after surgery was significantly lower in patients in the laser group (P < 0.05). PBM seems a promising, safe, cost-benefit therapeutic modality to reduce postoperative complications of CABG. Trial registration number: IRCT2016052926069N4 .
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Affiliation(s)
- Nooshafarin Kazemikhoo
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Dermatology at St George Hospital, University of NSW, Sydney, Australia
| | - Majid Kyavar
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Zahra Razzaghi
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereshteh Ansari
- Research Center for Evidence-Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.,Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Tehran, Iran
| | - Majid Maleki
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Alizadeh Ghavidel
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Maziar Gholampour
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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Affiliation(s)
- Areolino Pena Matos
- Department of Biological and Health Sciences, Federal University of Amapá, Macapá, Amapá, Brazil
| | - Maycon Sousa Pegorari
- Department of Biological and Health Sciences, Federal University of Amapá, Macapá, Amapá, Brazil
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Ezzati K, Fekrazad R, Raoufi Z. The Effects of Photobiomodulation Therapy on Post-Surgical Pain. J Lasers Med Sci 2019; 10:79-85. [PMID: 31360374 PMCID: PMC6499566 DOI: 10.15171/jlms.2019.13] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Introduction: One of the major complains after surgery is pain. Recent advances in the prevention and reduction of postoperative pain have provided several modalities. One of them is the use of laser irradiation on the surgical area. Objectives: To evaluate the effects of low level laser therapy (LLLT) on pain and side effects after surgery. Methods: In this research, databases such as: PubMed, Science Direct, Google Scholar, Springer and Cochrane were used and the words of laser therapy, photobiomodulation, therapeutic laser, low level laser therapy, surgery and pain were searched. Articles, including systematic reviews, original articles, case series, and clinical intervention studies related to these words, were studied. The language of all articles was English and consists of papers from 2009 until 2017. Results: A total of 370 papers were studied and 10 articles that met inclusion criteria were selected for this review. Few of these articles were followed up. Surgery included a wide range of surgeries including mastectomy, breast augment post-fracture, episiotomy, tonsillectomy and hernia. The methodological quality score on the PEDro scale was between 5 and 11. 8 trials reported positive effects and 2 trials reported negative effects. In order to study clinical effect size of laser therapy after surgery, only 4 papers met entry criteria and the mean effect sizes were 0.13 to 2.77. Accordingly, the best treatment protocol included a red laser dose of 4 J/cm2 for the post-operative pain of tonsillectomy, which was irradiated through the infra mandibular angle on the tonsils. Conclusion: LLLT may be an appropriate modality for reducing pain after surgery, nevertheless the effect size of this modality is variable. Therefore, further research based on proper protocols for these patients and follow-up of therapeutic course should be designed and implemented.
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Affiliation(s)
- Kamran Ezzati
- Neuroscience Research Center, Poorsina Hospital, Faculty of medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Reza Fekrazad
- Department of Periodontology, Dental Faculty - Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran
- International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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Moghadam MY. Low level laser therapy: a promising adjunct therapeutic modality for pain control after coronary artery bypass graft surgery. Korean J Pain 2019; 32:51-52. [PMID: 30671204 PMCID: PMC6333580 DOI: 10.3344/kjp.2019.32.1.51] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 05/29/2018] [Accepted: 06/01/2018] [Indexed: 12/23/2022] Open
Affiliation(s)
- Manijeh Yousefi Moghadam
- Department of Anesthesiology, Cardiac Anesthesia Fellowship, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
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White PF, Elvir Lazo OL, Galeas L, Cao X. Use of electroanalgesia and laser therapies as alternatives to opioids for acute and chronic pain management. F1000Res 2017; 6:2161. [PMID: 29333260 PMCID: PMC5749131 DOI: 10.12688/f1000research.12324.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/11/2017] [Indexed: 12/28/2022] Open
Abstract
The use of opioid analgesics for postoperative pain management has contributed to the global opioid epidemic. It was recently reported that prescription opioid analgesic use often continued after major joint replacement surgery even though patients were no longer experiencing joint pain. The use of epidural local analgesia for perioperative pain management was not found to be protective against persistent opioid use in a large cohort of opioid-naïve patients undergoing abdominal surgery. In a retrospective study involving over 390,000 outpatients more than 66 years of age who underwent minor ambulatory surgery procedures, patients receiving a prescription opioid analgesic within 7 days of discharge were 44% more likely to continue using opioids 1 year after surgery. In a review of 11 million patients undergoing elective surgery from 2002 to 2011, both opioid overdoses and opioid dependence were found to be increasing over time. Opioid-dependent surgical patients were more likely to experience postoperative pulmonary complications, require longer hospital stays, and increase costs to the health-care system. The Centers for Disease Control and Prevention emphasized the importance of finding alternatives to opioid medication for treating pain. In the new clinical practice guidelines for back pain, the authors endorsed the use of non-pharmacologic therapies. However, one of the more widely used non-pharmacologic treatments for chronic pain (namely radiofrequency ablation therapy) was recently reported to have no clinical benefit. Therefore, this clinical commentary will review evidence in the peer-reviewed literature supporting the use of electroanalgesia and laser therapies for treating acute pain, cervical (neck) pain, low back pain, persistent post-surgical pain after spine surgery (“failed back syndrome”), major joint replacements, and abdominal surgery as well as other common chronic pain syndromes (for example, myofascial pain, peripheral neuropathic pain, fibromyalgia, degenerative joint disease/osteoarthritis, and migraine headaches).
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Affiliation(s)
- Paul F White
- P.O. Box 548, Gualala, CA 95445, USA.,The White Mountain Institute, The Sea Ranch, CA, USA.,Department of Anesthesiology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 95445, USA
| | - Ofelia Loani Elvir Lazo
- Department of Anesthesiology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 95445, USA
| | | | - Xuezhao Cao
- Department of Anesthesiology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 95445, USA.,First Hospital of China Medical University, Shenyang, China
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Abstract
In a recent article from the Center for Disease Control, the authors addressed the current opioid epidemic in America and emphasized the importance of utilizing non-opioid analgesic alternatives to opioid medication for treating chronic pain. In cases where non-opioid analgesic drugs alone have failed to produce adequate pain relief, these authors suggested that non-pharmacologic therapies should also be considered. This Case Series describes a pilot study designed to evaluate a novel non-pharmacologic approach to treating long-standing (>1year) opioid dependency. The therapy involved the use of a high intensity cold laser device to treat three patients who had become addicted to prescription opioid-containing analgesic medication for treating chronic (residual) pain after a major operation. After receiving a series of 8-12 treatment sessions lasting 20-40min to the painful surgical area over a 3-4week period of time with the high intensity (42W) Phoenix Thera-lase laser device, an FDA-approved Class IV cold laser, these patients were able to discontinue their use of all oral opioid-containing analgesic medications and resume their normal activities of daily living. At a follow-up evaluation 1-2months after their last laser treatment, these patients reported that they have been able to control their pain with over-the-counter non-opioid analgesics and they have remained largely opioid-free. Further larger-scale studies are needed to verify these preliminary findings with this powerful cold laser in treating opioid-dependent patients.
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Affiliation(s)
- Paul F White
- Department of Anesthesiology, Cedars Sinai Medical Center, Los Angeles, CA, United States; The White Mountain Institute, The Sea Ranch, CA, United States.
| | - Ofelia Loani Elvir-Lazo
- Post-Doctoral Clinical Research Coordinator, Department of Anesthesiology, Cedars Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA, United States.
| | - Hector Hernandez
- Phoenix Thera-lase Systems LLC, 5454 La Sierra Dr., Dallas, TX, United States.
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