Clinical application of photobiomodulation therapy to reduce the severity of acute pain after septoplasty

Abstract

The purpose of the study: to evaluate the effectiveness of photobiomodulation (PBM) in the early postoperative period after septoplasty. Materials and methods: 62 patients have undergone septoplasty under general anaesthesia. Among them, there were 40 men and 22 women from 18 to 44 years of age. After septoplasty, the nasal cavity was tamponaded with foam tampons in glove rubber. The patients were divided into two groups of 31 participants, with the equal number of men and women in each of them. Patients of group 2 underwent PBM in 3 hours, 6 hours and 24 hours after septoplasty. The emitter heads generated infrared pulsed laser radiation of 0.890 microns wavelength and the power of 10 W. The emitter heads were installed for 2 minutes in the projection of the lateral cartilage and large cartilage of the nasal wing on both sides. In 48 hours after the operation, nasal swabs were removed in patients of both groups. In group 2, intranasal PBM therapy with a nozzle was performed in the continuous, modulated mode of operation in the red optical range, with the wavelength of 0.63 microns and radiation power of 8 mV for 2 minutes. Ultra-low frequency (ULF), hight frequency (HF), low frequency (LF), and total heart rate variability (HRV) power were evaluated, as well as the pain syndrome. Results. ULF was significantly lower in group 2 (8086±3003 msec2), compared to group 1 (18580±2067 msec2) (p<0.001). LF was significantly higher in group 1 (1871±405 msec2), compared to group 2 (1095±190 msec2) (p<0.005). In group 2, HF was lower – 1157±220 msec2 versus 1630±263 msec2 in group 1 (p<0.01). In group 2, the total HRV power was also lower (13498±3226 msec2) than in group 1 (26808±2371 msec2) (p<0.001). In the first three hours after the septoplasty, pain intensity did not differ between the groups. In group 2, pain decrease was observed after 6 hours, compared to the previous period (p<0.05). The pain continued to decrease in both groups, and 48 hours after septoplasty, patients either did not feel pain, or it was minimal and did not cause obvious discomfort. At the same time, in the period from 6 to 24 hours after septoplasty, patients who did not undergo PBM experienced significantly higher pain syndrome than patients with PBM (p<0.001). Conclusion. The use of PBM therapy with nasal tamponade after septoplasty helps to reduce pain severity as well as an inflammatory response to the surgical stress and, consequently, leads to less pronounced changes in the autonomic nervous system in response to the surgery.