Laser de baixa intensidade na modula????o do processo Inflamat??rio na preven????o da S??ndrome do insucesso da cirurgia espinhal
Autor(a) principal: | |
---|---|
Data de Publicação: | 2013 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da Uninove |
Texto Completo: | http://bibliotecatede.uninove.br/handle/tede/1148 |
Resumo: | Every year, over one million individuals worldwide were submitted to laminectomies, with a rate failure higher than 40%. Post laminectomy epidural adhesion is implicated as a main cause of ??????failed back surgery syndrome?????? and associated with high risk of complications during the revision surgery. The postoperative epidural scar can cause extradural compression or dural tethering, which lead to recurrent radicular pain and physical impairment. Several studies in the literature are signalizing that Low-Level-Laser-Therapy (LLLT) is proven to be an effective tool to assist the inflammatory process and wound healing, as well to prevent infection and dehiscence. The objectives of this project are to delineate and evaluate the LLLT effects in spinal surgery. A prospective randomized, controlled trial with a total of 48 patients, who underwent to laminectomy, were divided into 2 groups, as following: in 25 randomized patients, LLLT infrared, Power = 40mW, Fluence= 7.44 J/cm2 was applied during transoperatory phase, on the laminectomy site, on the subcutaneous tissue and surrounding the wound site. In the second group, 23 patients were induced to believe that they were getting the same treatment, avoiding psychological effect, although LLLT was not operating. In those groups, C reactive protein (CRP), lactic dehydrogenase and creatine kinase (CK) were assessed in the second and fifth days after surgery, digital temperature and visual analogue scale were measured, pre and post LLLT application. The drainage output were collected in the first and second days, following surgery in both groups. Interleukins 1, 4, 6, 8 and 10 and tumor necrosis factor alpha (TNF- ??) were evaluated. The results indicated temperature decrease, pain relief and accelerated wound healing in laser group. LLLT facilitates the wound cicatrization, due to a prompt resolution while acute inflammation, as suggested by the CRP chiefly drop from second to fifth postoperative day; in which the proliferation phase of healing demonstrated statistically significant values by fast fall in the laser group of CK, suggesting that these markers may guide LLLT treatment evolution. In conclusion, it was demonstrated that only three LLLT applications could assist better wound healing, reduce the lesion inflammation, decrease drainage output and promote analgesia in the PO post laminectomy with cost-effectiveness. |
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Chavantes, Maria Cristinahttp://lattes.cnpq.br/9684711829191051Oliveira, Jean Gon??alves dehttp://lattes.cnpq.br/8998261956379752Kurachi, Cristinahttp://lattes.cnpq.br/0194007981724312Duarte, Ivone da Silvahttp://lattes.cnpq.br/318070472975501705453406402http://lattes.cnpq.br/4951035987063239Holanda, Vanessa Milanesi2015-07-27T13:57:51Z2013-12-18Holanda, Vanessa Milanesi. Laser de baixa intensidade na modula????o do processo Inflamat??rio na preven????o da S??ndrome do insucesso da cirurgia espinhal. 2013. 59 f. Disserta????o( Programa de Mestrado em Medicina) - Universidade Nove de Julho, S??o Paulo .http://bibliotecatede.uninove.br/handle/tede/1148Every year, over one million individuals worldwide were submitted to laminectomies, with a rate failure higher than 40%. Post laminectomy epidural adhesion is implicated as a main cause of ??????failed back surgery syndrome?????? and associated with high risk of complications during the revision surgery. The postoperative epidural scar can cause extradural compression or dural tethering, which lead to recurrent radicular pain and physical impairment. Several studies in the literature are signalizing that Low-Level-Laser-Therapy (LLLT) is proven to be an effective tool to assist the inflammatory process and wound healing, as well to prevent infection and dehiscence. The objectives of this project are to delineate and evaluate the LLLT effects in spinal surgery. A prospective randomized, controlled trial with a total of 48 patients, who underwent to laminectomy, were divided into 2 groups, as following: in 25 randomized patients, LLLT infrared, Power = 40mW, Fluence= 7.44 J/cm2 was applied during transoperatory phase, on the laminectomy site, on the subcutaneous tissue and surrounding the wound site. In the second group, 23 patients were induced to believe that they were getting the same treatment, avoiding psychological effect, although LLLT was not operating. In those groups, C reactive protein (CRP), lactic dehydrogenase and creatine kinase (CK) were assessed in the second and fifth days after surgery, digital temperature and visual analogue scale were measured, pre and post LLLT application. The drainage output were collected in the first and second days, following surgery in both groups. Interleukins 1, 4, 6, 8 and 10 and tumor necrosis factor alpha (TNF- ??) were evaluated. The results indicated temperature decrease, pain relief and accelerated wound healing in laser group. LLLT facilitates the wound cicatrization, due to a prompt resolution while acute inflammation, as suggested by the CRP chiefly drop from second to fifth postoperative day; in which the proliferation phase of healing demonstrated statistically significant values by fast fall in the laser group of CK, suggesting that these markers may guide LLLT treatment evolution. In conclusion, it was demonstrated that only three LLLT applications could assist better wound healing, reduce the lesion inflammation, decrease drainage output and promote analgesia in the PO post laminectomy with cost-effectiveness.A cada ano, mais de um milh??o de pessoas ao redor do mundo s??o submetidas ?? cirurgia da coluna vertebral, com uma taxa de insucesso superior a 40%. A fibrose epidural p??s-laminectomia ?? apontada como a principal causa da s??ndrome do insucesso da cirurgia espinhal e est?? associada ao aumento do risco de complica????es durante a cirurgia de revis??o. A cicatriz p??s-operat??ria peridural pode causar compress??o extradural, resultando em dor radicular recorrente e d??ficits neurol??gico. In??meros estudos sinalizam que o laser de baixa intensidade (LBI) tem sido descrito como eficaz no aux??lio do decr??scimo da inflama????o e cicatriza????o de feridas cir??rgicas. Objetivos: Delinear e analisar os efeitos da laserterapia em cirurgia da coluna vertebral. Metodologia: Estudo prospectivo randomizado e controlado por placebo com 48 pacientes submetidos ?? laminectomia, divididos aleatoriamente em 2 grupos. No primeiro grupo, 25 pacientes receberam Laser no infravermelho (??= 804nm), Pot??ncia= 40mW, Flu??ncia= 7.44 J/cm2 durante a cirurgia nas seguintes ??reas: durante o transoperat??rio na dura-m??ter, sobre subcut??neo e sobre a pele; al??m do leito da ferida cir??rgica em 24h e 72h ap??s a cirurgia. No segundo grupo, 23 pacientes foram induzidos a acreditar que receberam o mesmo tratamento. Antes da cirurgia, al??m dos dias 2 e 5 p??s operat??rios (PO), foram coletadas amostras de sangue do paciente para estudo de PCR, DHL e CK. Antes e ap??s a laserterapia, a temperatura corp??rea foi medida por meio de term??metro digital e a dor foi avaliada por meio de escala anal??gica visual. Nos dias 1?? e 2?? PO, o d??bito do dreno foi coletado e analisado as citocinas foram avaliadas por ELISA interleucinas 1, 4, 6, 8, 10 e TNF-alfa do exsudato. Resultados: Demonstraram uma diminui????o de temperatura, al??vio da dor e cicatriza????o acelerada no grupo laser, al??m de uma redu????o do d??bito do dreno, contribuindo para redu????o da perda sangu??nea e evitando infec????o. O LBI facilita a repara????o de feridas, devido a uma resolu????o mais r??pida do processo inflamat??rio agudo, como foi sugerido pela maior queda do PCR do 2?? para o 5?? dia p??s-operat??rio. A fase de prolifera????o da cicatriza????o foi antecipada, j?? que os valores de CK revelaram uma queda mais r??pida no grupo do laser, sugerindo que esses marcadores inflamat??rios podem nortear o tratamento com LBI. Conclus??o: Demonstramos que tr??s aplica????es do LBI podem reduzir a inflama????o, auxiliar na drenagem e estimular uma melhor cicatriza????o de feridas, ajudando no processo de analgesia no p??s-operat??rio na cirurgia de coluna vertebral.Submitted by Nadir Basilio (nadirsb@uninove.br) on 2015-07-27T13:57:51Z No. of bitstreams: 1 Vanessa Milanesi Holanda.pdf: 1185275 bytes, checksum: 780810a027a0b0fd0a45e08edaa3f88d (MD5)Made available in DSpace on 2015-07-27T13:57:51Z (GMT). No. of bitstreams: 1 Vanessa Milanesi Holanda.pdf: 1185275 bytes, checksum: 780810a027a0b0fd0a45e08edaa3f88d (MD5) Previous issue date: 2013-12-18application/pdfporUniversidade Nove de JulhoPrograma de Mestrado em MedicinaUNINOVEBrasilSa??delaserterapiaanalgesiacicatriza????oinflama????ocitocinaslaminectomialasertherapy (LLLT)analgesiainflammationcytokineswound healinglaminectomyCIENCIAS DA SAUDELaser de baixa intensidade na modula????o do processo Inflamat??rio na preven????o da S??ndrome do insucesso da cirurgia espinhalinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesis8765449414823306929600info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da Uninoveinstname:Universidade Nove de Julho (UNINOVE)instacron:UNINOVEORIGINALVanessa Milanesi Holanda.pdfVanessa Milanesi Holanda.pdfapplication/pdf1185275http://localhost:8080/tede/bitstream/tede/1148/2/Vanessa+Milanesi+Holanda.pdf780810a027a0b0fd0a45e08edaa3f88dMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82089http://localhost:8080/tede/bitstream/tede/1148/1/license.txt7b5ba3d2445355f386edab96125d42b7MD51tede/11482017-05-26 11:49:33.151oai:localhost: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Biblioteca Digital de Teses e Dissertaçõeshttp://bibliotecatede.uninove.br/PRIhttp://bibliotecatede.uninove.br/oai/requestbibliotecatede@uninove.br||bibliotecatede@uninove.bropendoar:2017-05-26T14:49:33Biblioteca Digital de Teses e Dissertações da Uninove - Universidade Nove de Julho (UNINOVE)false |
dc.title.por.fl_str_mv |
Laser de baixa intensidade na modula????o do processo Inflamat??rio na preven????o da S??ndrome do insucesso da cirurgia espinhal |
title |
Laser de baixa intensidade na modula????o do processo Inflamat??rio na preven????o da S??ndrome do insucesso da cirurgia espinhal |
spellingShingle |
Laser de baixa intensidade na modula????o do processo Inflamat??rio na preven????o da S??ndrome do insucesso da cirurgia espinhal Holanda, Vanessa Milanesi laser terapia analgesia cicatriza????o inflama????o citocinas laminectomia lasertherapy (LLLT) analgesia inflammation cytokines wound healing laminectomy CIENCIAS DA SAUDE |
title_short |
Laser de baixa intensidade na modula????o do processo Inflamat??rio na preven????o da S??ndrome do insucesso da cirurgia espinhal |
title_full |
Laser de baixa intensidade na modula????o do processo Inflamat??rio na preven????o da S??ndrome do insucesso da cirurgia espinhal |
title_fullStr |
Laser de baixa intensidade na modula????o do processo Inflamat??rio na preven????o da S??ndrome do insucesso da cirurgia espinhal |
title_full_unstemmed |
Laser de baixa intensidade na modula????o do processo Inflamat??rio na preven????o da S??ndrome do insucesso da cirurgia espinhal |
title_sort |
Laser de baixa intensidade na modula????o do processo Inflamat??rio na preven????o da S??ndrome do insucesso da cirurgia espinhal |
author |
Holanda, Vanessa Milanesi |
author_facet |
Holanda, Vanessa Milanesi |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Chavantes, Maria Cristina |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/9684711829191051 |
dc.contributor.advisor-co1.fl_str_mv |
Oliveira, Jean Gon??alves de |
dc.contributor.advisor-co1Lattes.fl_str_mv |
http://lattes.cnpq.br/8998261956379752 |
dc.contributor.referee1.fl_str_mv |
Kurachi, Cristina |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/0194007981724312 |
dc.contributor.referee2.fl_str_mv |
Duarte, Ivone da Silva |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/3180704729755017 |
dc.contributor.authorID.fl_str_mv |
05453406402 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/4951035987063239 |
dc.contributor.author.fl_str_mv |
Holanda, Vanessa Milanesi |
contributor_str_mv |
Chavantes, Maria Cristina Oliveira, Jean Gon??alves de Kurachi, Cristina Duarte, Ivone da Silva |
dc.subject.por.fl_str_mv |
laser terapia analgesia cicatriza????o inflama????o citocinas laminectomia |
topic |
laser terapia analgesia cicatriza????o inflama????o citocinas laminectomia lasertherapy (LLLT) analgesia inflammation cytokines wound healing laminectomy CIENCIAS DA SAUDE |
dc.subject.eng.fl_str_mv |
lasertherapy (LLLT) analgesia inflammation cytokines wound healing laminectomy |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE |
description |
Every year, over one million individuals worldwide were submitted to laminectomies, with a rate failure higher than 40%. Post laminectomy epidural adhesion is implicated as a main cause of ??????failed back surgery syndrome?????? and associated with high risk of complications during the revision surgery. The postoperative epidural scar can cause extradural compression or dural tethering, which lead to recurrent radicular pain and physical impairment. Several studies in the literature are signalizing that Low-Level-Laser-Therapy (LLLT) is proven to be an effective tool to assist the inflammatory process and wound healing, as well to prevent infection and dehiscence. The objectives of this project are to delineate and evaluate the LLLT effects in spinal surgery. A prospective randomized, controlled trial with a total of 48 patients, who underwent to laminectomy, were divided into 2 groups, as following: in 25 randomized patients, LLLT infrared, Power = 40mW, Fluence= 7.44 J/cm2 was applied during transoperatory phase, on the laminectomy site, on the subcutaneous tissue and surrounding the wound site. In the second group, 23 patients were induced to believe that they were getting the same treatment, avoiding psychological effect, although LLLT was not operating. In those groups, C reactive protein (CRP), lactic dehydrogenase and creatine kinase (CK) were assessed in the second and fifth days after surgery, digital temperature and visual analogue scale were measured, pre and post LLLT application. The drainage output were collected in the first and second days, following surgery in both groups. Interleukins 1, 4, 6, 8 and 10 and tumor necrosis factor alpha (TNF- ??) were evaluated. The results indicated temperature decrease, pain relief and accelerated wound healing in laser group. LLLT facilitates the wound cicatrization, due to a prompt resolution while acute inflammation, as suggested by the CRP chiefly drop from second to fifth postoperative day; in which the proliferation phase of healing demonstrated statistically significant values by fast fall in the laser group of CK, suggesting that these markers may guide LLLT treatment evolution. In conclusion, it was demonstrated that only three LLLT applications could assist better wound healing, reduce the lesion inflammation, decrease drainage output and promote analgesia in the PO post laminectomy with cost-effectiveness. |
publishDate |
2013 |
dc.date.issued.fl_str_mv |
2013-12-18 |
dc.date.accessioned.fl_str_mv |
2015-07-27T13:57:51Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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publishedVersion |
dc.identifier.citation.fl_str_mv |
Holanda, Vanessa Milanesi. Laser de baixa intensidade na modula????o do processo Inflamat??rio na preven????o da S??ndrome do insucesso da cirurgia espinhal. 2013. 59 f. Disserta????o( Programa de Mestrado em Medicina) - Universidade Nove de Julho, S??o Paulo . |
dc.identifier.uri.fl_str_mv |
http://bibliotecatede.uninove.br/handle/tede/1148 |
identifier_str_mv |
Holanda, Vanessa Milanesi. Laser de baixa intensidade na modula????o do processo Inflamat??rio na preven????o da S??ndrome do insucesso da cirurgia espinhal. 2013. 59 f. Disserta????o( Programa de Mestrado em Medicina) - Universidade Nove de Julho, S??o Paulo . |
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http://bibliotecatede.uninove.br/handle/tede/1148 |
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por |
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por |
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UNINOVE |
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Brasil |
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Sa??de |
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Universidade Nove de Julho |
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