Effect of warming anaesthetic solutions on pain during dental injection. A randomized clinical trial (original) (raw)
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Pakistan Armed Forces Medical Journal
Objective: To evaluate the effectiveness of using anesthesia at 42°C (107.6°F) for the insight of pain as dental sedative in contrast to its administration at room temperature 21°C throughout the procedure of maxillary infiltration. Study Design: Double-blind, Split-Mouth randomized clinical trial (Clinical trial number: ISRCTN79560957) Place and Duration of Study: Department of Armed Forces Institute of Dentistry, Rawalpindi, from Jan to Jun 2021. Methodology: A total of 38 patients were examined, undergoing maxillary premolar extractions for orthodontic purposes. Group- A received local anesthesia injection with the anesthesia warmed to 42°C (107.6°F) and group- B patients receiving local anesthesia injection with anesthesia at room temperature. The injection point was placed in the mucobuccal fold apically in the middle of maxillary premolars using a 27G short needle and injecting 0.9 mL of the anesthetics at the speed of 0.15 mL/second. Patients were instructed to grade intensit...
Local and regional anesthesia, 2018
The purpose of this study is to determine the effectiveness of warming anesthesia on the control of the pain produced during the administration of dental anesthesia injection and to analyze the role of Transient Receptor Potential Vanilloid-1 nociceptor channels in this effect. A double-blind, split-mouth randomized clinical trial was designed. Seventy-two volunteer students (22.1±2.45 years old; 51 men) from the School of Dentistry at the Universidad Austral de Chile (Valdivia, Chile) participated. They were each administered 0.9 mL of lidocaine HCl 2% with epinephrine 1:100,000 (Alphacaine) using two injections in the buccal vestibule at the level of the upper lateral incisor teeth. Anesthesia was administered in a hemiarch at 42°C (107.6°F) and after 1 week, anesthesia was administered by randomized sequence on the contralateral side at room temperature (21°C-69.8°F) at a standardized speed. The intensity of pain perceived during the injection was compared using a 100 mm visual a...
Journal of Endodontics, 2012
Introduction: This study was performed to investigate the effect of topical anesthesia on pain during needle penetration and infiltration injection as well as the effect of pain during injection on success rate of anesthesia in maxillary central incisors. Methods: In a crossover double-blind study, 25 volunteers randomly received either topical anesthesia or placebo before infiltration injection with prilocaine for their maxillary central incisors in 2 separate appointments. The pain after needle penetration and during injection was separately recorded. An electric pulp tester was used to evaluate the success of the anesthetic injection. Data were analyzed by McNemar, Wilcoxon, and c 2 tests. Results: Overall for 50 injections, 72% of the teeth had successful anesthesia. No significant difference was found between placebo and topical anesthetic groups for the pain of needle penetration as well as pain during injection (P > .05). The volunteers who reported moderate-to-severe pain during injection showed no significant difference in the success rate of anesthesia compared with those with no or mild pain during injections (P > .05). Conclusions: Use of topical anesthesia had no significant effect on pain during either needle penetration or injection. Pain during injection had no significant effect on the success of anesthesia. (J Endod 2012;38:1553-1556
Clinical Oral Investigations, 2019
Objectives The present study evaluates the efficacy of warm local anesthetic (37°C) administration and injections of local anesthetics at room temperature (21°C) in reducing pain during injections in children undergoing dental procedures. Materials and methods Enrolled for this split-mouth randomized clinical study were 100 children aged 5-8 years. Within the random crossover design selected for the study, each patient was randomly assigned to receive either a body or room temperature local anesthesia in the first session and the other local anesthesia on the second session. During the injection, the Wong-Baker Faces Pain Rating Scale was used as a subjective measure of discomfort, and heart rate as an objective measure. The Face, Legs, Arms, Cry, and Consolability (FLACC) scale was used to record the child's pain, based on the perception of the dental assistant. The data were analyzed using a Wilcoxon sign rank test and a paired t test. Results Based on the score of the Wong-Baker Faces Pain Rating Scale, the FLACC scale, and heart rate, the sensation of pain during dental injection in both girls and boys is statistically significantly lower at body temperature than at room temperature (p < 0.05). Conclusions It was determined that the application of local anesthetic at body temperature reduces dental injection pain significantly when compared with local anesthetics administered at room temperature. Clinical relevance The successful management of dental injection pain is an important issue during dental procedures in children. Accordingly, warming the local anesthesia prior to use in children can be recommended to clinicians.
Journal of Dental Research, Dental Clinics, Dental Prospects, 2019
Background. This study assessed the effect of cooling the soft tissue site on the perception of pain in children undergoing local anesthesia for routine dental procedures. Methods. One hundred children, 6‒14 years of age, were assigned to either of the two study groups, i.e., group 1 (infiltration) and group 2 (block anesthesia). One side of the arch served as the test side, where an ice pretreatment (IP) of the soft tissue of the injection site was carried out using a tube of ice for one minute, whereas the opposite side served as the control, where no ice pretreatment (WIP) was carried out. This was followed by the gradual injection of local anesthetic solution. The children’s pain perception was assessed by VAS, WB-FPRS and SEM scales. The data were analyzed statistically. Results. WBS, VAS and SEM scores were significantly different between the WIP and IP in both groups, indicating that ice was effective in reducing the pain perception in children. Intergroup comparison revealed...
Pesquisa Brasileira em Odontopediatria e Clínica Integrada
Objective: To evaluate the efficacy of pre-cooling and the use of higher gauged needles in reducing pain during local anesthetic infiltration. Material and Methods: We conducted a split-mouth randomized controlled trial among 70 patients who require bilateral maxillary local anesthetic (LA) injections for dental treatment. After applying the topical anesthetic, each participant received four local anesthetic injections, two on buccal and two palatal sides. At each visit, the participants received one buccal and one palatal infiltration based on the randomization. On the buccal aspect, participants received LA with a 26G needle injection on one side (control) and a 31G needle (test) on the contralateral side. On the Palatal aspect, participants either received LA with a 31G needle on one side (control). In contrast, the opposite side was preceded by topical ice application (iced cotton swab) before LA with a 31G needle (test). Both the visits were spaced with a gap of 7-10 days based on the participants' feasibility. Participants were asked to rate the pain on a visual analog scale independently for buccal and palatal LA injections. Results: On the Buccal aspect, the mean pain scores were 2.74 ± 1.26 and 2.11 ± 1.26 for control and test groups, respectively (p=0.002). On the Palatal aspect, the mean pain scores were 4.14 ± 1.49 and 4.3 ± 1.80 for control and test groups, respectively (p=0.295). Conclusion: Significant lower pain scores were reported with higher gauge needles (31G) when compared to traditional (26G) needles on the buccal aspect. No significant difference was seen with pre-cooling the injection site on the palatal aspect when used with higher gauged needles (31G).
Does the warming of local anaesthetic reduce the pain of its injection
Emergency Medicine Journal, 1989
One hundred and fifty-seven patients who warranted the injection of local anaesthetic were divided into two groups. One group received local anaesthetic at room temperature (21°C) and the other at body temperature (37C). The pain resulting from the injection was assessed using a visual analogue scale. There was no significant difference in the level of pain experienced by the two patient groups. It is concluded that no advantage is gained by the warming of local anaesthetic before its administration.
SciDoc Publishers, 2021
Introduction: Topical cooling has long been used to help heal injured tissues. Local external cooling has been used for treating sprains, burns, fractures, bruising and insect bites. There is very little information in the literature regarding the benefits of pre-cooling the injection site, to reduce the pain and discomfort caused due to injection. Aim: To do a comparative study on the effectiveness of cold stimulus instead of topical anaesthetic during injection of local anaesthetic solution. Materials and Methods: Patients will be subjected to LA injections after one of the following mucosal preparations-1. no pretreatment ; 2. a 2 min application of 15% lidocaine topical anaesthetic; 3. application of cold stimulus. Patients will then give a score on the injection discomfort after each administration on a 100 mm visual analogue scale. Results: With application of cold stimulus using ice sticks prior to local anaesthetic injection, 60% of the study population had mild discomfort/pain and 40% had moderate discomfort/pain. Conclusion: The results of this study showed that topical application of cold stimulus prior to the injection of local anaesthetic solution, helps reducing the pain and discomfort caused by the injection.
International Journal of Dentistry and Oral Science, 2021
Introduction: Topical cooling has long been used to help heal injured tissues. Local external cooling has been used for treating sprains, burns, fractures, bruising and insect bites. There is very little information in the literature regarding the benefits of pre-cooling the injection site, to reduce the pain and discomfort caused due to injection. Aim: To do a comparative study on the effectiveness of cold stimulus instead of topical anaesthetic during injection of local anaesthetic solution. Materials and Methods: Patients will be subjected to LA injections after one of the following mucosal preparations-1. no pretreatment ; 2. a 2 min application of 15% lidocaine topical anaesthetic; 3. application of cold stimulus. Patients will then give a score on the injection discomfort after each administration on a 100 mm visual analogue scale. Results: With application of cold stimulus using ice sticks prior to local anaesthetic injection, 60% of the study population had mild discomfort/pain and 40% had moderate discomfort/pain. Conclusion: The results of this study showed that topical application of cold stimulus prior to the injection of local anaesthetic solution, helps reducing the pain and discomfort caused by the injection.