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光生物调节对分娩镇痛的影响:一项对照随机临床试验。

The Effect of Photobiomodulation on Analgesia During Childbirth: A Controlled and Randomized Clinical Trial.

机构信息

Biophotonics Applied to Health Sciences, and University Nove de Julho, São Paulo, Brazil.

Post Graduation Program in Rehabilitation Sciences, University Nove de Julho, São Paulo, Brazil.

出版信息

Photobiomodul Photomed Laser Surg. 2021 Apr;39(4):265-271. doi: 10.1089/photob.2020.4976. Epub 2021 Mar 23.

Abstract

Pain during labor can be a barrier when choosing vaginal delivery. In an attempt to relief pain during labor, several pharmacological and nonpharmacological methods are proposed. To assess the effect of light-emitting diode (LED) photobiomodulation on analgesia during labor. A clinical trial was conducted with 29 women who were divided into two groups: G1 (experimental group-LED) and G2 (control group-hot shower). In the experimental group, an LED plate with red and infrared merged [red 660 ± 20 nm, 5 mW/cm, 3 J per LED (108 J) and infrared 850 ± 20 nm, 5 mW/cm, 3 J per LED (108 J), total energy = 216 J] was placed on the subjects' dorsal region, at the level of T10 to S4, for 10 min, with the plate automatically turning off. Hot shower at controlled temperature was offered for 30 min. To verify the effect of LED on analgesia during labor, the following variables were assessed: (1) perception of pain, (2) fetal well-being assessed by cardiotocography or intermittent auscultation of fetal heart rate, (3) Apgar score at minutes 1 and 5 after birth, and (4) labor duration. There was a statistically significant difference ( < 0.05) in pain reduction evidenced by a millimetric visual scale, before and after application on G1-LED (7.92 ± 1.78). Regarding the other variables, there was no statistical difference between the groups when comparing fetal well-being, Apgar score and labor duration. It is concluded that LED can be considered an alternative, since it caused pain reduction without changing other parameters during labor, compared with hot shower, a method included in hospital protocols, proving to be safe. Clinical Trial Registration number: NCT03496857.

摘要

分娩疼痛可能是选择阴道分娩的障碍。为了缓解分娩疼痛,提出了几种药理学和非药理学方法。评估发光二极管(LED)光生物调节对分娩镇痛的效果。一项临床试验纳入了 29 名女性,将其分为两组:G1(实验组-LED)和 G2(对照组-热水淋浴)。在实验组中,将一个带有红色和红外线的 LED 板[红色 660±20nm,5mW/cm,每个 LED 产生 3J(108J)和红外线 850±20nm,5mW/cm,每个 LED 产生 3J(108J),总能量=216J]放置在受试者的背部区域,T10 到 S4 水平,持续 10 分钟,板会自动关闭。为受试者提供控温的热水淋浴 30 分钟。为了验证 LED 对分娩镇痛的效果,评估了以下变量:(1)疼痛感知,(2)通过胎儿心电图或间歇性听诊胎儿心率评估胎儿健康状况,(3)出生后 1 分钟和 5 分钟的 Apgar 评分,以及(4)分娩时间。在 G1-LED 应用前后,使用毫米视觉量表评估疼痛减轻程度,差异有统计学意义( < 0.05)(7.92±1.78)。关于其他变量,在比较胎儿健康状况、Apgar 评分和分娩时间时,两组之间没有统计学差异。结论是,与医院方案中包含的热水淋浴方法相比,LED 可以被认为是一种替代方法,因为它在分娩期间不会改变其他参数,同时可以减轻疼痛,证明是安全的。临床试验注册号:NCT03496857。

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