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BACKGROUND: Carboxytherapy may generate local pain that is considered the main limiting factor in clinical practice. Transcutaneous electric nerve stimulation (TENS) is widely used in the control of acute pain; however, the effect of TENS on pain relief during carboxytherapy has not been studied to date. AIMS: To assess the effect of TENS on pain intensity during carboxytherapy in patients with cellulite in the gluteal region. PATIENTS/METHODS: This randomized clinical trial was conducted with 84 patients, 18-44 years of age, who had moderate cellulite in the gluteal region, according to Cellulite Severity Scale, but never received carboxytherapy. Patients were randomized into 3 groups: active TENS, placebo TENS, and control group. For the intervention, skin depressions with cellulite were outlined, and the gluteal area to be treated was defined. The subcutaneous injection of CO2 was performed using 0.30 × 13 mm-needles at a 45° angle, with a controlled flow rate of 100 mL/min maintained for 1 minute at each puncture site. The parameters for TENS were as follows: frequency of 100 Hz and pulse duration of 200 µs; TENS intensity was adjusted until the patient reported strong paresthesia. The visual numeric pain rating scale was used to assess pain intensity after each puncture. RESULTS: The active TENS group reported lower pain intensity compared to the placebo TENS (P < .0001) and control (P < .0001) groups. CONCLUSIONS: Transcutaneous electric nerve stimulation (TENS) was effective in reducing pain intensity during carboxytherapy in patients with cellulite in the gluteal region.

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OBJECTIVE: This study evaluated the effects of high- (HF) and low-frequency (LF) transcutaneous electrical nerve stimulation on angiogenesis and myofibroblast proliferation in acute excisional wounds in rat skin. DESIGN: This was an experimental controlled and randomized study. PARTICIPANTS: An excisional wound was made on the back of 90 adult male EPM1-Wistar rats using an 8-mm punch. INTERVENTIONS: The animals were randomly assigned to the HF group (80 Hz), LF group (5 Hz), or control group. Transcutaneous electrical nerve stimulation (pulse duration, 200 microseconds; current amplitude, 15 mA) was delivered (session length, 60 minutes) on 3 consecutive days. MEAN OUTCOME MEASURE: Immunohistochemistry was performed on postoperative days 3, 7, and 14 for counting blood vessels and myofibroblasts. MEAN OUTCOME RESULTS: The LF group had significantly more blood vessels than the HF group on day 3 (P = .004). The HF group had significantly less blood vessels than did the control group on days 7 (P = .002) and 14 (P = .034) and less myofibroblasts than did both the LF and control groups on day 3 (P = .004) and less than did the control group on day 7 (P = .001). CONCLUSION: There seems to be a benefit to the use of LF transcutaneous electrical nerve stimulation in the healing of acute excisional wounds, but further studies are warranted.

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BACKGROUND: Although several studies have demonstrated the effects of low-level laser therapy (LLLT) on skin flap viability, the role of higher doses has been poorly investigated. OBJECTIVE: To investigate the inhibitory effect of the LLLT (λ=670 nm) on the viability of random skin flaps in a rat model using an irradiation energy of 2.79 J at each point. METHODS: Sixteen Wistar rats were randomly assigned into two groups: sham laser irradiation (n=8); and active laser irradiation (n=8). Animals in the active laser irradiation group were irradiated with a 670 nm diode laser with an energy of 2.79 J/point, a power output 30 mW, a beam area of 0.028 cm(2), an energy density of 100 J/cm(2), an irradiance of 1.07 W/cm(2) for 93 s/point. Irradiation was performed in 12 points in the cranial skin flap portion. The total energy irradiated on the tissue was 33.48 J. The necrotic area was evaluated on postoperative day 7. RESULTS: The sham laser irradiation group presented a mean (± SD) necrotic area of 47.96±3.81%, whereas the active laser irradiation group presented 62.24±7.28%. There was a significant difference in skin-flap necrosis areas between groups (P=0.0002). CONCLUSION: LLLT (λ=670 nm) increased the necrotic area of random skin flaps in rats when irradiated with an energy of 2.79 J (100 J/cm(2)).

HISTORIQUE: Plusieurs études ont démontré les effets de la thérapie laser de faible intensité (TLFI) sur la viabilité des lambeaux cutanés, mais le rôle de plus fortes doses a été peu évalué. OBJECTIF: Examiner l'effet inhibiteur de la TLFI (λ=670 nm) sur la viabilité de lambeaux cutanés aléatoires d'un modèle murin au moyen d'une énergie d'irradiation de 2,79 J à chaque point. MÉTHODOLOGIE: Les chercheurs ont réparti 16 rats Wistar en deux groupes aléatoires : irradiation laser factice (n=8) et irradiation laser active (n=8). Les animaux du groupe d'irradiation laser active ont été irradiés à l'aide d'une diode laser de 670 nm à une énergie de 2,79 J/point, une puissance de 30 mW, un faisceau de 0,028 cm2, une densité énergétique de 100 J/cm2 et une radiation de 1,07 W/cm2 pendant 93 s/point. Douze points ont été irradiés sur la portion du lambeau cutané crânien. L'énergie totale irradiée sur les tissus s'élevait à 33,48 J. Les chercheurs ont évalué la zone nécrosée le septième jour après l'opération. RÉSULTATS: Le groupe d'irradiation laser factice présentait une zone nécrosée moyenne de (± ÉT) 47,96±3,81 %, tandis que le groupe d'irradiation laser active présentait une zone de 62,24±7,28 %. On constatait une différence importante entre les zones nécrosées des lambeaux cutanés des deux groupes (P=0,0002). CONCLUSION: La TLFI (λ=670 nm) accroissait la zone nécrosée des lambeaux cutanés murins aléatoires lorsqu'ils étaient irradiés par une énergie de 2,79 J (100 J/cm2).