Does audiovisual distraction reduce dental anxiety in children under local anesthesia? A systematic review and meta-analysis

Oral Diseases ◽  
2018 ◽  
Vol 25 (2) ◽  
pp. 416-424 ◽  
Author(s):  
C Zhang ◽  
D Qin ◽  
L Shen ◽  
P Ji ◽  
J Wang

2021 ◽  
Author(s):  
Thaynara Nascimento Oliveira ◽  
Igor Bustamante Ferreira dos Santos ◽  
Gabriela Luiza Nunes Souza ◽  
Renata Negreiros Alvarenga ◽  
Saul Martins Paiva ◽  
...  


2020 ◽  
Author(s):  
Matteo Melini ◽  
Andrea Forni ◽  
Francesco Cavallin ◽  
Matteo Parotto ◽  
Gastone Zanette

Abstract Background: Dental anxiety is a condition associated with avoidance of dental treatment and increased medical and surgical risks. This systematic review aims to summarize available evidence on conscious sedation techniques used for the management of Dental anxiety in patients scheduled for third molar extraction surgery, to identify best approaches and knowledge gaps. Methods: A comprehensive search was conducted including MEDLINE/Pubmed, EMBASE, SCOPUS, clinicaltrials.gov and the Cochrane Database of Systematic Reviews through March 2019. Only randomized controlled trials were included. PRISMA guidelines were followed. Risk of bias was appraised as reported in the Cochrane Handbook for Systematic Reviews of Interventions. Results: Seventeen RCTs with a total of 1,788 patients were included. Some aspects limited the feasibility of a meaningful meta-analysis, thus a narrative synthesis was conducted. Conscious sedation was associated with improvement in Dental anxiety in six studies. One study reported lower cortisol levels with midazolam vs. placebo, while another study found significant variation in perioperative renin levels with remifentanil vs. placebo. Conclusions: This review found inconclusive and conflicting findings about the role of Conscious sedation in managing Dental anxiety during third molar extraction surgery. Relevant questions remain unanswered due to the lack of consistent, standardized outcome measures. Future research may benefit from addressing these limitations in study design.



2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Chuying Shi ◽  
Jinqiu Yuan ◽  
Benny Zee

Background. Phacoemulsification under local anesthesia is regarded as the major surgery for cataract treatment. Recent research has compared the pain perception between the first eye and the second eye during phacoemulsification. However, these studies have also yielded controversial findings. Consequently, we performed a systematic review and a meta-analysis to investigate the difference in the pain perception between the first and second eyes during phacoemulsification. Method. We searched the PubMed, EMBASE, and Cochrane CENTRAL databases for the studies published up to October 5, 2018. Prospective observational studies were included. The meta-analysis was conducted by means of random-effects model and fixed-effects model according to the heterogeneity. Evaluation of the methodological quality of studies was based on Newcastle-Ottawa Scale (NOS). Results. Overall, eight studies were included in the meta-analysis. The analysis of pooled data showed that the pain scores of the first eye shortly after surgery under local anesthesia were significantly lower as compared to the second eye (WMD: 0.69; 95% CI: 0.40, 0.98; P<0.00001). The average pain scores of the first eye shortly after surgery under the topical anesthesia were also lower than those of the second eye (WMD: 1.08; 95% CI: 0.79, 1.36; P<0.00001). Conversely, anxiety scores in the first eye surgery were significantly higher than those in the second eye surgery (SMD: −0.40; 95% CI: −0.64, −0.16; P=0.001). However, the difference of the pain scores accessed on the first postoperative day between the first and second eye surgeries (WMD: −0.05; 95% CI −0.40, 0.31; P=0.79) as well as cooperation grades of patients between the first and second eye surgeries (WMD: 0.35; 95% CI −0.07, 0.76; P=0.10) was not statistically significant. Conclusion. Patients experienced more pain in the surgery of the second eye than that of the first eye, which probably related to lower anxiety before the second surgery. It suggests that we should consider preoperative intervention to reduce the perceived pain during second eye cataract surgery.



2020 ◽  
Author(s):  
Chen Gao ◽  
Chunyan Weng ◽  
Chenghai He ◽  
Jingli Xu ◽  
Liqiang Yu

Abstract Background Arteriovenous fistulae (AVF) are the hemodialysis access modality of choice for patients with end-stage renal disease. However, they have a high early failure rate. Good vascular access is essential to manage long-term hemodialytic treatment, but some anesthesia techniques directly affect venous diameter as well as intra- and post- operative blood flow. The main purpose of this meta-analysis was to compare the results of regional and local anesthesia for arteriovenous fistula creation in end-stage renal disease.Methods: We conducted a systematic review and meta-analysis to synthesize evidence from 7 randomized controlled trials (565 patients) and 2 observational studies (524 patients) aim to evaluate the safety and efficacy of regional anesthesia (RA) versus local anesthesia (LA) in AVF surgical construction.Results: Pooled data showed that RA was associated with higher primary patency rates than LA (odds ratio [OR], 1.88; 95% confidence interval [CI], 1.24 - 2.84; P = 0.003; I 2 = 31%; Figure 2a). Additionally, brachial artery diameter was significantly increased in the RA versus LA group (mean difference [MD] = 0.83; 95% CI: 0.75 - 0.92; P < 0.001; I 2 = 97%) and the need for intra- as well as post- operative pain killers was significantly less (RA, p = 0.0363; LA, p = 0.0318). Moreover, operation duration was significantly reduced in the RA (67.5 ± 8.9 min) versus LA (134.7 ± 14.8 min) group (p = 0.0007).Conclusions: In conclusion, compared with LA, RA shows higher primary patency rates and it also associated with significantly better intra- as well as post- operative pain control, reduced operative times, which are extremely important in patients with end-stage renal disease and severe comorbidities.





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