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Clinical evaluation of Transcutaneous Blood Laser Irradiation (TBLI) on hemodynamic changes in anesthesia of dogs

 

Authors: Shahabeddin.M1, Sharifi.D2, Mokmeli .S3, Abarkar.M4, Shirani.D5, Ghazaleh.N6, Bahonar.A, 7

Faculty of Veterinary Medicine, University of Tehran. Tehran. Iran

1 &6 Post-graduate students of Faculty of Veterinary Medicine., University of Tehran. Iran

2.Davood Sharifi, Professor of Department of Veterinary Surgery, Faculty of Veterinary Medicine .University of Tehran. Tehran Iran.P.O.Box 14155-6453:e.mail dsharifi@ut.ac.ir

3MD, Anesthesiologist- Research manager in Canadian Optic & Laser (COL) center,

4 Faculty Member of Islamic Azad University, Karaj branch, 5, 7

Key Words: Intravenous, Laser therapy, Anesthesia, Low level laser, Recovery, Surgery

Abstract:

Introduction: The blood laser irradiation is a biological therapeutic method which is pioneered in Russia and was used in some studies to modulate surgical stress. The aims of this study were evaluation the effects of blood laser irradiation on hemodynamic parameters, the amount of anesthetic drugs in maintenance of anesthesia and duration of recovery.

Materials & Methods: After the ethical permissibility of institutional animal investigation, 15 dogs (25.0 ± 3.6 kg) were divided into three groups (n=5). The group I as control group received Lasertherapy. The group II was premedicated with neuroleptanalgesics including Midazolam plus Fentanyl, and induction of anesthesia was done by Propofol, then the dogs were intubated for maintenance of anesthesia by isoflurane 1%. In addition to neuroleptanalgesics combined with Isoflurane, group III received Trans-cutaneous Blood Laser Irradiation (TBLI) through the cephalic venous line by a portable laser probe (P=100mW, WL=650nm, A=1cm2, T=20 min, Power density=0.1MW/Cm2) immediately after intubation. The changes in hemodynamic parameters including heart rate, blood pressure, SpO2 and the level of blood cortisol were measured before and after the induction of anesthesia on 5, 10 , 15, 45 and 60 minutes. Dogs’ behavior and the level of consciousness were evaluated after the end of anesthesia and in the recovery room. The results were analyzed by SPSS-16 Software (One–Way ANOVA, exact Fisher Test and paired sample T-Test).

Results: No complication from anesthesia and blood laser radiation was noticed, and despite of some variation in collective data there was no significant difference between homodynamic parameters, blood cortisol level, SpO2 and the doses of isoflurane. However all of dogs in group III had smooth recovered and attained full conscious after end of anesthesia. No agitation, noisy sound, aggressive movement and behavior were observed in this group. All dogs in this group had shorter recovery time compare to other groups.

Conclusion: This study showed that (TBLI) is a safe method without any side effect to add anesthetic procedure. There was no deterioration effect on hemodynamic parameters and the consumption amount of isoflurane. It improved recovering symptoms after anesthesia. All dogs in laser group had higher levels of consciousness after anesthesia and recovery. The results indicated that application of laser during anesthesia will have qualitative effects on depth of anesthesia and   prepared ground for smooth recovery without post-anesthetic complications.

 

Does low level laser therapy enhance the efficacy of intravenous regional anesthesia?

 

SholehNesioonpour, MD1*, Reza Akhondzadeh1, MD, SoheilaMokmeli2, MD, ShahnamMoosavi3, MD, MandanaMackie1, MD

1- Department of Anesthesiology, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

2- Research Manager, Canadian Optic & Laser (COL) Center, BC, Canada

3- Department of orthopedics, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

Running title: Laser therapy and regional anesthesia

 

ABSTRACT

Purpose: To assess the efficacy of low level laser therapy (LLLT) added to intravenous regional anesthesia (IVRA) on improving pain relate to surgical fixation of distal radius fracture.

Methods and materials: This is a single-blind placebo-controlled randomized clinical trial, with 48 candidates for surgical fixation of distal radius fracture. They were randomized into an intervention group (n=24) who received 808 nm laser irradiation as 4 J/point for 20 seconds over ipsilateral three nerve roots in the cervical region corresponding to C5-C8 vertebrae and 808 nm laser irradiation as 0.1 J/cm2for five minutes in a tangential scanning mode over the affected extremity. The control group (n=24) received turned-off probe practice in the same time schedule. Both groups received the same IVRA protocol using 2% lidocaine.

Results: The mean VAS values were significantly lower in the laser-assisted group than in the lidocaine-only group at all measurements during and after operation (P<0.05). The mean time for the first need for fentanyl administration during operation was prolonged in the laser group (P=0.04). The total amount of fentanyl administered to patients was significantly less in the laser-assisted group (P=0.003).The laser group needed significantly less amounts of pethidine for pain relief (P=0.001),and in a later time (P=0.002),in comparison to the lidocaine only group. There was no difference between groups in terms of mean arterial pressure and heart rate.

Conclusion: Addition of Gallium-Aluminum-Arsenide (GaAlAs) laser irradiation tointravenous regional anesthesia is safe and improves pain during and after operation.

Keywords: low level laser therapy (LLLT), intravenous regional anesthesia (IVRA), distal radius fracture, postoperative pain, tourniquet

 

 

THE EFFECT OF LOW-LEVEL LASER THERAPY (LLLT) ON POST OPERATIVE PAIN AFTER TIBIAL FRACTURE SURGERY


A prospective double blind randomized clinical trial

Anesth Pain Med. 2014 August; 4(3): e17350.  DOI: 10.5812/aapm.17350

Published online 2014 June 21.

Sholeh Nesioonpour1, Soheila Mokmeli2, Salman Vojdani1*, Ahmadreza Mohtadi1,

Reza Akhondzadeh1, Kaveh Behaeen1, Shahnam Moosavi3 , Sarah Hojjati4

Abstract

Background: Postoperative pain is a common complication that can lead to serious morbidities and delayed recovery.

Objective: The aim of this study was to investigate the effect of LLLT on acute pain after tibial fracture surgery.

Material and Methods: After the approval of the ethics committee of Jundishapur University of Medical Sciences, 54 candidates for tibial fracture surgery signed the consent form. The patients were divided randomly into two groups, control and laser. The groups had a similar type of surgery and spinal anesthesia. Laser group was treated with IR and red lasers at the end of the surgery, while the control group received placebo laser. Each tibial fracture was radiated from four sides by contact technique in total dose 9J/cm2.

Lasers Parameters (Manufactured by Canadian Optic and Laser Center):

  • GaALAs (PLP-IR), 808nm, 300mw, Continuous mode, Power density 0.3=W/cm2, Area = 1cm2, Dose= 6/cm2, Time= 20S/point).
  • GaALInP (PLP-R), 650nm, 100mw, Continuous mode, Power density 0.1=W/cm2, Area=1cm2, Dose=3/cm2, Time= 30S/point).

Patients were evaluated for pain intensity according to the visual analogue scale (VAS) and the amount of analgesic consumption for 24 hours after surgery.

Results: Laser group experienced lower pain intensity compared to control group at 2, 4, 8, 12, and 24 hours after surgery (P-value< 0.05). The amount of opioid in laser group was significantly lower than control group (Pvalue=0.008).

Conclusions: LLLT is a proper method to reduce postoperative pain because it is painless, safe, non-invasive and can be applied easily in surgery or recovery room.

Key words: Low-Level Laser, Postoperative Pain, Tibial Fracture, Surgery

 

 

Effect of 780 nm low level laser therapy on the regeneration of injured sciatic nerves after end to end anastomosis in the rabbit: Histological analysis

 

Mohammad Ashrafzadeh Takhtfooladi*1, Davood Sharifi2, Soheila Mokmeli3, GholamrezaAbedi1, Iraj Sohrabi Haghdost4, Pezhman Mortazavi4, Hamidreza Fattahian1, Ahmad Asghari1, Mohammad Abedi4, Mojtaba Ziaee5

1-Department of Surgery, Faculty of Specialized Veterinary Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran.

2-Department of Surgery & Radiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran.

3-Anesthesiologist and Pain Specialized, Canadian Optic and Laser Center (COL Center), Victoria BC Canada.

4-Department of Pathology, Faculty of Specialized Veterinary Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran.

5-Department of Pharmacology, Miyaneh Branch, Islamic Azad University, Miyaneh, Iran.

 

ABSTRACT

Peripheral nerves are often exposed to injuries from traumatic origins, such as crushing impact and total transections, resulting in decreases or complete loss of sensory and motor capabilities in corresponding area of innervations. Laser irradiation is one of the therapeutic methods for the recovery of degenerated peripheral nerves. The present study focuses on the effect of 780 nm laser irradiation on the regeneration of injured sciatic nerves after end to end anastomosis in the rabbit. Twenty adult white New Zealand male rabbits were used, where the injury of the type axontmesis of the right sciatic nerve under general anesthesia was approximated using proline 6-0. The rabbits were randomly distributed in 2 groups with 10 rabbits each. In group I, Arsenate of Gallium Laser with the extension of wave of 780 nm, 10 mW power with 1.0 J/cm

2 -irradiation with 10 seconds for each Cm2 with penetration of 4cm, in the pulsed form.  The laser therapy in group I was initiated on the post-surgical first day, where all the rabbits with application once a day for 15 days or 10 minutes each rabbit. Rabbits in group II not had given treatment (control group). The samples of transected nerves were collected and prepared of histological analysis on the 90 days, they were analyzed and  quantitifid  for  Schwann  cells,  mylenic  axons  with  larger  diameter  and  neurons.  The histological aspect was essentially normal on proximal segments of the right sciatic nerve on both experimental groups, with a regular distribution of narrow and wide nervous fibers and an apparently normal proportion between myelin sheaths thickness and fibers diameter, numerous non-myelinated  fibers,  intraneural  blood  vessels,  and  fibroblasts  were  also  observed.  In  the  proximal  and  intermediate  segments (injury site), blood vessels were more prevalent and thicker for group I than group II. Thick fibers with very thin myelin sheaths were prevalent in the intermediate segment in both groups I and II. Schwann cells with reactive appearance nuclei, characteristic of synthesis activity, as well as typical images of axonal sprouting were more prevalent on group I, while Wallerian degeneration was more evident on group II.  Small-gauge fibers and thin myelin sheaths were prevalent, although thick fibers and thick myelin sheaths were also frequent on group II next to a large number of Schwann cells with reactive-appearance nucleus and images of axonal sprouting. In this segment, Wallerian degeneration was not so evident for group I and even II. This study suggests that postoperative low-power Ga-As-Al laser irradiation was able to accelerate and potentialize the peripheral nerve regeneration process of rabbits within 15 days of irradiation.