scholarly journals Evaluation of 2-Stage Injection Technique in Children

2016 ◽  
Vol 63 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Valasingam Sandeep ◽  
Manikya Kumar ◽  
P. Jyostna ◽  
Vijay Duggi
Keyword(s):  
Nerve Block ◽  
Local Anesthetic ◽  
Rating Scale ◽  
Effective Means ◽  
Inferior Alveolar Nerve ◽  
Pediatric Dentistry ◽  
Conventional Technique ◽  
Injection Pain ◽  
Rank Test ◽  
Injection Technique

Effective pain control during local anesthetic injection is the cornerstone of behavior guidance in pediatric dentistry. The aim of this study was to evaluate the practical efficacy of a 2-stage injection technique in reducing injection pain in children. This was a split-mouth, randomized controlled crossover trial. One hundred cooperative children aged 7 to 13 years in need of bilateral local anesthetic injections (inferior alveolar nerve block, posterior superior alveolar nerve block, or maxillary and mandibular buccal infiltrations) for restorative, endodontic, and extraction treatments were recruited for the study. Children were randomly allocated to receive either the 2-stage injection technique or conventional technique at the first appointment. The other technique was used at the successive visit after 1 week. Subjective and objective evaluation of pain was done using the Wong–Baker FACES Pain Rating Scale (FPS) and Sound Eye Motor (SEM) scale, respectively. The comparison of pain scores was done by Wilcoxon sign-rank test. Both FPS and SEM scores were significantly lower when the 2-stage injection technique of local anesthetic nerve block/infiltration was used compared with the conventional technique. The 2-stage injection technique is a simple and effective means of reducing injection pain in children.

Effectiveness of Two Flavored Topical Anesthetic Agents in Reducing Injection Pain in Children: A Comparative Study

2012 ◽  
Vol 37 (1) ◽  
pp. 15-18 ◽  
Author(s):  
A Deepika ◽  
R Chandrasekhar Rao ◽  
C Vinay ◽  
KS Uloopi ◽  
VV Rao
Keyword(s):  
Nerve Block ◽  
Primary Teeth ◽  
Inferior Alveolar Nerve ◽  
Clinical Effectiveness ◽  
Pediatric Dentistry ◽  
Pain Scale ◽  
Injection Pain ◽  
Inferior Alveolar Nerve Block ◽  
Topical Anesthetic ◽  
Anesthetic Agents

Topical anesthesia is widely advocated in pediatric dentistry practice to reduce pain and anxiety produced by administration of local anesthesia. There are different combinations of topical anesthetic agents that are marketed worldwide. However, sparse literature reports exist regarding clinical efficacy of these agents. Aim: To compare the clinical effectiveness of two strawberry flavored topical anesthetics viz. Precaine⁰ (8% Lidocaine + 0.8% Dibucaine) and Precaine⁰ B (20% Benzocaine) in children before intra oral local anesthetic injections and for extraction of mobile primary teeth. Study Design: This triple blind clinical study included sixty children divided equally under three techniques — palatal injections, inferior alveolar nerve block and extraction of mobile primary teeth. Both the products were used alternately using split mouth design in two visits and the child's pain response was assessed using VAS and SEM pain scale. The scores obtained were subjected to statistical analysis. Results: Precaine⁰ has shown lower mean scores in all the techniques under both the pain scales, but were statistically insignificant. Gender wise comparison has also shown lower mean scores for Precaine⁰ for both males and females, however these were statistically insignificant. On visit wise comparison, Precaine⁰ B reported significant lower scores (p<0.05) in visit 2 compared to visit 1 for inferior alveolar nerve block and extraction of mobile primary teeth under SEM pain scale. Conclusion: Precaine⁰ (8% Lidocaine + 0.8% Dibucaine) can be used as effectively as Precaine⁰ B (20% Benzocaine).

scholarly journals Inferior Alveolar Nerve Block Injection Pain Using a Computer-Controlled Local Anesthetic Device (CCLAD): A Prospective, Randomized Study

2018 ◽  
Vol 65 (4) ◽  
pp. 231-236
Author(s):  
Sara Fowler ◽  
Chase Crowley ◽  
Melissa Drum ◽  
Al Reader ◽  
John Nusstein ◽  
...  
Keyword(s):  
Nerve Block ◽  
Local Anesthetic ◽  
Supine Position ◽  
Inferior Alveolar Nerve ◽  
Needle Insertion ◽  
Injection Pain ◽  
Inferior Alveolar Nerve Block ◽  
Needle Placement ◽  
Solution Deposition ◽  
Computer Controlled

There is evidence that the Computer-Controlled Local Anesthetic Device (CCLAD) decreases the pain of oral injections. The purpose of this study was to evaluate injection pain of the inferior alveolar nerve block (IANB) using the CCLAD in an upright position versus a supine position. Additionally, we evaluated solution deposition pain with the CCLAD when compared to previous studies using a traditional syringe. One hundred ten asymptomatic subjects were randomly given IANBs using 2% lidocaine with 1:100,000 epinephrine while in an upright sitting position and supine position, at 2 different appointments, spaced at least 2 weeks apart. Each subject rated the pain for needle insertion, needle placement, and solution deposition on a Heft-Parker visual analogue scale. Pain ratings were compared between the upright and supine positions using a repeated-measures analysis of variance with post hoc testing using the Tukey-Kramer procedure. Moderate to severe pain was reported by 10% to 13% of the patients for needle insertion, 74% to 75% for full needle placement, and 8% to 10% for solution deposition. There was no significant difference between groups for phases of the injection. When comparing the injection phases within the groups, the needle placement phase of the injection was statistically more painful than both the needle insertion phase and solution deposition phase (p = .0001). Using the CCLAD, IANB injection pain of the supine and upright positions was not statistically different. Needle placement was the most painful phase of the injection. Solution deposition pain was less with the CCLAD when compared to other studies of the IANB using a traditional syringe.

scholarly journals The Effects of a 2-Stage Injection Technique on Inferior Alveolar Nerve Block Injection Pain

2006 ◽  
Vol 53 (4) ◽  
pp. 126-130 ◽  
Author(s):  
John Nusstein ◽  
Geoffrey Steinkruger ◽  
Al Reader ◽  
Mike Beck ◽  
Joel Weaver
Keyword(s):  
Nerve Block ◽  
Inferior Alveolar Nerve ◽  
Injection Pain ◽  
Injection Technique ◽  
Inferior Alveolar Nerve Block

scholarly journals RCT on the effectiveness of the intraligamentary anesthesia and inferior alveolar nerve block on pain during dental treatment

2021 ◽  
Author(s):  
Bahaa R. Youssef ◽  
Andreas Söhnel ◽  
Alexander Welk ◽  
Mohamed H. Abudrya ◽  
Mohamed Baider ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Nerve Block ◽  
Rating Scale ◽  
Dental Treatment ◽  
Inferior Alveolar Nerve ◽  
Numeric Rating Scale ◽  
Inferior Alveolar Nerve Block ◽  
Posterior Teeth ◽  
Mandibular Posterior Teeth ◽  
Numeric Rating

Abstract Objective To compare the effectiveness and complications of intraligamentary anesthesia (ILA) with conventional inferior alveolar nerve block (IANB) during injection and dental treatment of mandibular posterior teeth. Materials and methods In this randomized, prospective clinical trial, 72 patients (39 males, 33 females), scheduled for dental treatment of mandibular posterior teeth, were randomly allocated to ILA group (n = 35) received ILA injection or IANB group (n = 37) received the conventional IANB. Our primary outcome was to assess pain and stress (discomfort) during the injection and dental treatment, using the numeric rating scale (NRS) from 0 to 10 (0 = no pain, 10= the worst pain imaginable), whereas recording 24-h postoperative complications was our secondary outcomes. Results Patients in ILA group reported significantly less pain during injection when compared with IANB group (p = 0.03), while pain during dental treatment was similar in both groups (p = 0.2). Patients in both groups also reported similar law values of discomfort during treatment (p = 0.7). Although no signs of nerve contact or any other postoperative complications were observed, five patients in IANB group (none in ILA group) reported temporary irritations. Conclusion This study showed equivalent effectiveness of both intraligamentary anesthesia and conventional inferior alveolar nerve block, for pain control during routine dental treatment of mandibular posterior teeth. Nevertheless, ILA showed significantly less pain during injection. No major postoperative complications in both groups were observed. Clinical relevance ILA could be considered as an effective alternative for routine dental treatment. Trial registration NCT04563351

scholarly journals POSITIVE ASPIRATION AND ITS SIGNIFICANCE DURING INFERIOR ALVEOLAR NERVE BLOCK - A PROSPECTIVE STUDY

2014 ◽  
Vol 04 (03) ◽  
pp. 008-010
Author(s):  
Muralee Mohan ◽  
Tarun Jain ◽  
Rajendra Prasad ◽  
S M Sharma ◽  
Anju Gopinathan T.
Keyword(s):  
Blood Vessel ◽  
Nerve Block ◽  
Local Anaesthetic ◽  
Inferior Alveolar Nerve ◽  
Conventional Technique ◽  
Basic Rule ◽  
Inferior Alveolar Nerve Block ◽  
Oral Surgical Procedures ◽  
Anaesthetic Solution ◽  
Local Anaesthetic Solution

Abstract Background and aims: It is a basic rule to aspirate before injection when giving an inferior alveolar nerve block because the local anaesthetic may fail if the injection is given into a blood vessel, and the local anaesthetic solution may have undesirable systemic effects. There are reports that indicate aspiration is not performed in every injection. The aim of the present study was to assess the incidence of intravascular needle entrance in inferior alveolar nerve block injections. Patients and methods: Interns and postgraduates of our institute performed inferior alveolar nerve block injections using conventional technique in 250 patients undergoing minor oral surgical procedures. The results of aspiration were reported. Aspirable syringes and 27 gauge long needles were used, and the method of aspiration was similar in all cases.Data were analyzed using t-test. Results: 20% of inferior alveolar nerve block injections were aspiration positive. Of all injections, 15.8% were intravascular on the right side and 14.8% were intravascular on the left. There were no statistically significant differences between right and left injection sites (P = 0.778). Between the ages of 9 and 19 the incidence of intravascular penetration was significantly greater than at other ages (10/28 compared with 39/222, P = 0.04). Conclusion: Aspiration of the syringe after the needle had been placed in position for an inferior alveolar nerve block (but before the anaesthetic solution was injected) in 250 patients showed that the tip of the needle was in a blood vessel in 49 (20%). Aspiration of blood was significantly more common in patients aged 9–19 years than in all others (P=0.04). It seems that side of injection has no considerable effect in incidence of intravascular needle entrance.

Nitrous Oxide Reduces Pain Associated With Local Anesthetic Injections

2019 ◽  
Vol 23 (6) ◽  
pp. 602-607 ◽  
Author(s):  
Matthew J. Lin ◽  
Danielle P. Dubin ◽  
Hooman Khorasani
Keyword(s):  
Nitrous Oxide ◽  
Local Anesthetic ◽  
Rating Scale ◽  
Injection Pain ◽  
Mohs Micrographic Surgery ◽  
Micrographic Surgery ◽  
Topical Anesthetic ◽  
Pain Scores ◽  
Male Sex ◽  
Pain Rating Scale

Background Local anesthetic injections can be painful and distressing. Objective The aim of this study was to determine whether nitrous oxide, ice, vibration, or topical anesthetic improves analgesia for local anesthetic injections. Method A cohort study of 400 patients undergoing Mohs micrographic surgery with local anesthetic was conducted. Patients received no intervention ( n = 200), ice ( n = 50), topical anesthetic cream ( n = 50), vibration device ( n = 50), or nitrous oxide ( n = 50). Pain was rated using the Visual Analogue Scale (VAS) and Wong-Baker FACES Pain Rating Scale. Results Without intervention, mean VAS was 4.2 and FACES was 4.6. Nitrous oxide was the most successful in reducing pain (mean VAS 1.6 vs. 4.2, P < .01, FACES 1.2 vs. 4.6, P < .01). Topical ice reduced pain (mean VAS 3.0 vs. 4.2, P < .01, FACES 3.0 vs. 4.6, P < .01). Vibration reduced pain (mean VAS 3.5 vs. 4.2, P < .01, FACES 3.6 vs. 4.6, P < .01). Higher pain scores were associated with age <50 ( P = .02), male sex ( P = .05), and surgery on the nose, lip, ear, or eyelid ( P = .02). Conclusion Nitrous oxide, ice, and vibration reduce injection pain. These interventions are especially useful for younger males undergoing surgery on the nose, lip, ear, or eyelid.

scholarly journals Efficacy of Pulpal Anesthesia Using a Needle-less Syringe

2020 ◽  
Vol 67 (4) ◽  
pp. 200-206
Author(s):  
Coleman Christensen ◽  
Stephen C. Arnason ◽  
Ross Oates ◽  
Michael Crabtree ◽  
John W. Kersey ◽  
...  
Keyword(s):  
Inferior Alveolar Nerve ◽  
Contralateral Side ◽  
Injection Pain ◽  
Injection Technique ◽  
Single Tooth ◽  
Tooth Type ◽  
Vas Scores ◽  
The Difference ◽  
Mandibular Teeth ◽  
Pulpal Anesthesia

The purpose of this study was to investigate the manufacturer's claims regarding a novel needleless intraligamentary local anesthesia injection device (Numbee, BioDent) to provide effective single tooth anesthesia. Investigators compared the Numbee with a traditional inferior alveolar nerve block (IANB) during a restorative procedure on mandibular teeth. A randomized, split-mouth design was conducted with 15 adult subjects receiving an IANB on one side and a Numbee injection on the same tooth type on the contralateral side. Subjects recorded injection pain using the Visual Analog Scale (VAS) and their preferred injection technique. Anesthesia was considered profound with 2 consecutive electric pulp tester readings of 80. If subjects became symptomatic during the restorative procedure, rescue anesthesia was administered. The difference in VAS scores for injection pain between the Numbee and the IANB was not significant (p = .078). For the IANB, the incidence of profound anesthesia was 46%, and required rescue anesthesia was 20%. For the Numbee, the incidence of profound anesthesia was 0%, and required rescue anesthesia was 60%. Subject preference was evenly split (50/50%) between the 2 techniques. The IANB outperformed the Numbee device for achieving profound anesthesia and requiring less rescue anesthesia.

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