title: Does low-level laser therapy enhance the efficacy of intravenous regional anesthesia?
abstract: BACKGROUND
  The use of intravenous regional anesthesia (IVRA) is limited by pain resulting from the application of tourniquets and postoperative pain.
  
  
  OBJECTIVE
  To assess the efficacy of low-level laser therapy added to IVRA for improving pain related to surgical fixation of distal radius fractures.
  
  
  METHODS
  The present double-blinded, placebo-controlled, randomized clinical trial involved 48 patients who were undergoing surgical fixation of distal radius fractures. Participants were randomly assigned to either an intervention group (n=24), who received 808 nm laser irradiation as 4 J⁄point for 20 s over ipsilateral three nerve roots in the cervical region corresponding to C5-C8 vertebrae, and 808 nm laser irradiation as 0.1 J⁄cm2 for 5 min in a tangential scanning mode over the affected extremity; or a control group (n=24), who underwent the same protocol and timing of laser probe application with the laser switched off. Both groups received the same IVRA protocol using 2% lidocaine.
  
  
  RESULTS
  The mean visual analogue scale scores were significantly lower in the laser-assisted group than in the lidocaine-only group on all measurements during and after operation (P<0.05). The mean time to the first need for fentanyl administration during the operation was longer in the laser group (P=0.04). The total amount of fentanyl administered to patients was significantly lower in the laser-assisted group (P=0.003). The laser group needed significantly less pethidine for pain relief (P=0.001) and at a later time (P=0.002) compared with the lidocaine-only group. There was no difference between the groups in terms of mean arterial pressure and heart rate.
  
  
  CONCLUSIONS
  The addition of gallium-aluminum-arsenide laser irradiation to intravenous regional anesthesia is safe, and reduces pain during and after the operation.
authors.forename: Sholeh
authors.initials: S
authors.lastname: Nesioonpour
authors.forename: Reza
authors.initials: R
authors.lastname: Akhondzadeh
authors.forename: Soheila
authors.initials: S
authors.lastname: Mokmeli
authors.forename: Shahnam
authors.initials: S
authors.lastname: Moosavi
authors.forename: Mandana
authors.initials: M
authors.lastname: Mackie
authors.forename: Morteza
authors.initials: M
authors.lastname: Naderan
mesh_terms: D000328:Adult; D000765:Anesthesia, Conduction; D000779:Anesthetics, Local / Q000008:administration & dosage; D004311:Double-Blind Method; D005260:Female; D005592:Fracture Fixation / Q000009:adverse effects; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine