Eficácia da terapia de fotobiomodulação na dor e cicatrização de episiotomias e lacerações perineais graus 2 e 3 após parto vaginal: um estudo observacional de coorte-prospectivo

Abstract

Episiotomies (PE) and perineal lacerations (PL) after normal delivery can present complications such as pain, edema and infection. Currently, anti-inflammatories, analgesics, sitz baths and ice packs are indicated. Photobiomodulation therapy (PBM) has emerged as a promising technology for the treatment of pain and scar stimulation in PE and PL. This was an observational, prospective cohort study, carried out at the Maternal and Child University Hospital of the State University of Ponta Grossa-PRA, where the application of PBM is already routinely offered in the puerperal bed daily throughout the hospitalization as an adjuvant measure to the hospital's standard treatment (anti-inflammatories, ice packs and analgesics). This study aimed to evaluate the effects of PBM on analgesia and perineal healing in episiotomies and grade 2 and 3 lacerations after vaginal delivery. The PBM parameters used in the service are: 808 nm, 100 mW at 5 points around the PL or PE with 4 J/cm². All patients (183) who underwent PE or suffered PL grade 2 and 3 during the period were evaluated. a 6-month recruitment period in the hospital's obstetrics service. The main outcome assessed collected from the medical records was the daily assessment of pain using the numerical pain scale (NPS) before and after BMF, in addition to the assessment of perineal healing using the REEDA scale. The comparison of the NPS and REEDA between the groups that used and did not use the laser were made with the repeated measures ANOVA test considering the study covariates and with the Welch's t-test for two samples, with ordinary least squares regression (OLS) and the Propensity Score Estimate (PSM). Of the 183 participants followed up in the service during the recruitment period, 149 patients chose to undergo treatment with BMF on the first day and 34 chose conventional treatment. The mean NPS and REEDA of the patients who underwent laser decreased compared to the patients who underwent conventional treatment, with a statistical difference between the groups. The data allow us to conclude that laser treatment was effective in reducing the perception of pain and also in improving tissue healing.