title: Effect of low-level laser therapy on pain and perineal healing after episiotomy: A triple-blind randomized controlled trial.
abstract: Episiotomy is associated with perineal pain and healing complications. The low-level laser therapy (LLLT) reduces pain and inflammation and stimulates the healing process. This study aimed to assess the effect of LLLT on pain and perineal healing after an episiotomy.
  
  
  
  A randomized, triple-blind, parallel clinical trial with 54 postpartum women who had a spontaneous birth with a right mediolateral episiotomy. The women were randomized into two groups: the experimental group (applications of LLLT n = 29) or the placebo group (simulated LLLT applications n = 25). Three sessions of real or sham irradiation were performed at 6-10 hours after normal birth, and the 2nd and 3rd applications were performed at 20-24 hours and 40-48 hours after the first session, respectively. Perineal pain was recorded using a Numeric Scale ranging from 0 to 10 (0 = absence and 10 = worst pain). Perineal healing was assessed using the redness, oedema, ecchymosis, discharge, and approximation (REEDA) scale. Both groups were assessed four times: in each of the three LLLT sessions and at 7-10 days after normal birth. The groups were compared using the Student's t, Mann-Whitney, and Chi-square tests.
  
  
  
  There was no significant difference between the groups regarding perineal healing after LLLT. The perineal pain scores were statistically higher in the experimental group in the first assessment and after the third LLLT. There was no significant difference between the groups related to the perineal pain scores 7-10 days after normal birth.
  
  
  
  The use of LLLT does not provide any benefit for treating postpartum perineal trauma using these specific protocol and parameters. Lasers Surg. Med. 49:181-188, 2017. © 2016 Wiley Periodicals, Inc.
authors.affiliation: School of Arts Sciences and Humanities of University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Marina B
authors.initials: MB
authors.lastname: Alvarenga
authors.affiliation: Department of Maternal Child and Psychiatric Nursing, School of Nursing, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Sonia Maria Junqueira Vasconcellos
authors.initials: SM
authors.lastname: de Oliveira
authors.affiliation: Department of Maternal Child and Psychiatric Nursing, School of Nursing, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Adriana A
authors.initials: AA
authors.lastname: Francisco
authors.affiliation: Midwifery Programme, School of Arts, Sciences and Humanities, Public Health Graduate Program, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Flora Maria B
authors.initials: FM
authors.lastname: da Silva
authors.affiliation: Laboratory of Radiation Dosimetry and Medical Physics, Institute of Physics, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Sousa
authors.affiliation: Medical School Clinical Epidemiology Unit, Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Moacyr Roberto
authors.initials: MR
authors.lastname: Nobre
mesh_terms: D000293:Adolescent; D000328:Adult; D004841:Episiotomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D028022:Low-Level Light Therapy; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000532:radiotherapy*; D010502:Perineum; D014945:Wound Healing / Q000528:radiation effects*; D055815:Young Adult
keywords: episiotomy; low-level laser therapy; pain; perineum; postpartum period