Photobiomodulation for Pain, Healing, and Analgesic Use after Perineal Lacerations: A Double-Blind Randomized...

Approximately 60% of women experience some degree of perineal laceration following vaginal delivery. Although there is evidence supporting the use of photobiomodulation (PBM) for pain relief and wound healing in various conditions, there is a lack of studies on its effect on these lacerations. Our hypothesis is that PBM aids in pain management and healing in perineal lacerations/episiotomies in hospitalized women.

A randomized, controlled, double-blind clinical trial in women with grade I/II lacerations and/or episiotomy, assigned to the intervention group (660 nm; 4 J) or placebo group (device turned off). Primary outcome was perineal pain at rest and during movements, measured using the numeric rating scale. Secondary outcome was healing, measured using the REEDA (redness, edema, ecchymosis, discharge, approximation) scale. Additionally, in-hospital analgesic consumption, self-perception of perineal laceration healing, and satisfaction with the intervention were analyzed. Analysis performed pre-intervention (6-12 h postpartum), post-intervention 1 (6-12 h post-first intervention), post-intervention 2 (12-18 h post-first intervention), and follow-up (7-15 days postpartum). Analysis was performed on an intention-to-treat basis using the Mann-Whitney test.

A total of 59 women participated (intervention 30; placebo 29), most of whom were primiparous. The intragroup analysis shows a reduction in perineal pain during rest and movements, with improved healing in both groups. No difference was observed in intergroup analysis. The intervention group consumed fewer analgesics and had a longer interval between doses than the placebo group.

Photobiomodulation (660 nm; 4 J) applied within 24 h postpartum, did not result in clinical improvement in pain or healing in women with perineal lacerations/episiotomies.