Comparison of Two Standard Scales for Pain Perception during Local Anesthetic Injection in Children

Background: Local anesthetic injection is one of the most anxiety- provoking procedure for both children and adult patients in dentistry. A computerized system for slow delivery of local anesthetic has been developed as a possible solution to reduce the pain related to the local anesthetic injection. Study design: The present study was conducted to evaluate and compare pain perception rates in pediatric patients with computerized system and traditional methods, both objectively and subjectively. Study design: It was a randomized controlled study in one hundred children aged 8-12 years in healthy physical and mental state, assessed as being cooperative, requiring extraction of maxillary primary molars. Children were divided into two groups by random sampling - Group A received buccal and palatal infiltration injection using Wand, while Group B received buccal and palatal infiltration using traditional syringe. Visual Analog scale (VAS) was used for subjective evaluation of pain perception by patient. Sound, Eye, Motor (SEM) scale was used as an objective method where sound, eye and motor reactions of patient were observed and heart rate measurement using pulse oximeter was used as the physiological parameter for objective evaluation. Results: Patients experienced significantly less pain of injection with the computerized method during palatal infiltration, while less pain was not statistically significant during buccal infiltration. Heart rate increased during both buccal and palatal infiltration in traditional and computerized local anesthesia, but difference between traditional and computerized method was not statistically significant. Conclusion: It was concluded that pain perception was significantly more during traditional palatal infiltration injection as compared to computerized palatal infiltration, while there was no difference in pain perception during buccal infiltration in both the groups

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High-Dose Daily Opioid Administration and Poor Functional Status Intensify Local Anesthetic Injection Pain in Cancer Patients

January 2018 - Pain Physician ◽

10.36076/ppj.2013/16/e247 ◽

2013 ◽

Vol 3;16 (3;5) ◽

pp. E247-E256

Author(s):

Kyung Bong Yoon

Keyword(s):

Functional Status ◽

Cancer Patients ◽

Local Anesthetic ◽

Pain Perception ◽

Injection Pain ◽

High Dose ◽

Pain Scores ◽

Clinical Pain ◽

Local Anesthetic Injection ◽

And Behavior

Background: Evidence for opioid-induced hyperalgesia (OIH) has been shown in animal and human studies, but the clinical implications of this phenomenon remain unclear. Objectives: We examined whether cancer patients taking opioids differ in their sensitivity to a clinical pain stimulus using a local anesthetic injection compared to those not taking opioids. We also evaluated the effect of the opioid dose, duration of opioid therapy, and patients’ pain severity and functional status on this clinical pain stimulus. Study Design: Prospective observational study. Setting: University outpatient department for interventional pain management, Republic of Korea. Methods: Eighty-two cancer patients including 20 patients not taking opioids (non-opioid group) and 62 taking opioids (opioid group) who were scheduled for an interventional procedure were enrolled in this study. Patients received a standardized subcutaneous injection of lidocaine prior to a full dose of local anesthetic (LA). Before the injection, patients completed the Brief Pain Inventory (BPI) questionnaire and were asked to rate their current pain using numeric rating scales. Immediately following the injection, LA injection-specific pain was evaluated using pain intensity, unpleasantness, and behavior pain scores. Results: LA injection-specific pain intensity, unpleasantness, and behavior pain score were significantly higher in the opioid group compared with the non-opioid group (P < 0.001). In the opioid group, these post-injection pain scores were higher in patients taking high-dose opioids than those taking low doses (P < 0.05). In addition, we observed a strong correlation between the baseline BPI pain interference score and the LA injection-specific pain score (r = 0.695, P < 0.001). Limitations: This study is limited by its sample size and observational design. Various opioid medications, which were not standardized, may have inadvertently biased our results. Finally, the pain assessed by a brief stimulus does not fully reflect disturbances in endogenous pain inhibitory processes. Conclusion: The results of this study suggest that opioid medication is an important contributing factor to pain perception accompanying LA injection, and cancer patients using high-dose opioids may be highly susceptible to hyperalgesic responses to this clinical stimulus. We also suggest that the possible presence of OIH may be intensified among cancer patients with poor physical and psychosocial functional status. Key words: Adverse effects; analgesics, opioid; anesthetics, local; cancer; hyperalgesia; injections, subcutaneous; nociceptive pain; pain measurement; pain perception; quality of life

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A Comparative Study of Children's Pain Reactions and Perceptions to AMSA Injection using CCLAD versus Traditional Injections

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.34.3.3201l74255560520 ◽

2010 ◽

Vol 34 (3) ◽

pp. 217-222 ◽

Cited By ~ 10

Author(s):

May Feda ◽

Najlaa Al Amoudi ◽

Aly Sharaf ◽

Azza Hanno ◽

Najat Farsi ◽

...

Keyword(s):

Local Anesthetic ◽

Pain Perception ◽

Negative Impact ◽

Scientific Evidence ◽

Pediatric Dentistry ◽

Anesthetic Techniques ◽

Pain Reaction ◽

Time Required ◽

Local Anesthetic Injection ◽

Children's Pain

Pain control is an important part of dentistry, particularly in pediatric dentistry. Recently, a computer-controlled local anesthetic delivery system (CCLAD) has been developed to reduce pain related to the local anesthetic injection. In conjunction with this technology, a new approach to the anterior and middle superior alveolar nerves (AMSA) has been induced. Studies evaluating the CCLAD in pediatric dentistry showed variable results regarding its use in pediatric dentistry. Further evaluation of this technique is needed to provide sound scientific evidence on the use of the CCLAD at this specific injection site in children. Aim:To assess children's pain reactions and pain perceptions of the AMSA injection using the CCLAD compared to the traditional buccal/palatal injections. Materials and methods: Children's pain reactions and perceptions to both techniques were measured in a group of 40 children who received both anesthetic techniques alternatively on two visits. The pain reactions were scored using the SEM scale, whereas the pain perception was evaluated by the Eland color scale. Statistical analysis was carried out using SPSS version 10.0.Results: The AMSA injection delivered with the CCLAD had significantly lower mean pain reaction scores compared to traditional buccal and palatal injections. The prolonged injection time required for delivering the CCLAD injection had no negative impact on the children. The children's pain perception scores when using the CCLAD were also significantly lower compared to the traditional injection. Conclusion: The AMSA injection delivered with the CCLAD was found to be a promising device, and had significantly lower pain reaction and perception scores compared to the traditional buccal and palatal injections.

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CORRELATION BETWEEN WONG-BAKER FACES PAIN SCALE AND SALIVARY ALPHA-AMYLASE LEVEL IN CHILDREN AGED 6–11 YEARS

International Journal of Applied Pharmaceutics ◽

10.22159/ijap.2017.v9s2.34 ◽

2018 ◽

Vol 9 ◽

pp. 133

Author(s):

Hastin Dian Anggraeni ◽

Margaretha Suharsini ◽

Ike Siti Indiarti ◽

Faraghea Yumasdhika

Keyword(s):

Pain Intensity ◽

Local Anesthetic ◽

Extraction Procedure ◽

Pain Scale ◽

Alpha Amylase ◽

Primary Tooth ◽

Amylase Level ◽

Salivary Alpha Amylase ◽

Local Anesthetic Injection ◽

Spearman’S Correlation

Objective: Several studies have tried to objectively assess pain measurements. The Wong-Baker Faces Pain Scale (WBFPS) is an instrument that is commonly used to assess pain intensity in children. This study aimed to analyze the correlation between the WBFPS and salivary alpha-amylase (SAA) level during a tooth extraction procedure with a local anesthetic injection in children aged 6–11 years.Methods: Twenty-five children aged 6–11 years who were to undergo the extraction of a primary tooth at the Dental and Oral Educational Hospital, Faculty of Dentistry Universitas Indonesia, were enrolled in this study. From all children, saliva was collected using a disposable saliva strip shortly after local anesthetic injection, and the SAA activity was then determined using a portable Nipro Cocoro Meter device. The WBFPS was measured at the same time. The correlation between the WBFPS and the SAA level was analyzed using Spearman’s correlation test. The statistically significant level was set at p≤0.05.Results: There was a significant correlation between the WBFPS and SAA level (p=0.002, r=0.581).Conclusion: Our data suggest that the SAA level might be a good index for objective pain intensity assessment.

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Use of test dose allows early detection of subdural local anesthetic injection with lumbar plexus block

Journal of Clinical Anesthesia ◽

10.1016/j.jclinane.2016.11.011 ◽

2017 ◽

Vol 37 ◽

pp. 111-113 ◽

Cited By ~ 1

Author(s):

Bradley H. Lee ◽

Matthias Braehler

Keyword(s):

Early Detection ◽

Local Anesthetic ◽

Test Dose ◽

Lumbar Plexus ◽

Lumbar Plexus Block ◽

Local Anesthetic Injection ◽

Plexus Block

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Evaluation of Changing Serum Blood Glucose Levels after Local Anesthetic Injection during Tooth Extraction

Journal of Dentomaxillofacial Radiology Pathology and Surgery ◽

10.18869/acadpub.3dj.4.2.15 ◽

2015 ◽

Vol 4 (2) ◽

pp. 15-19

Author(s):

Kamal Qaranizade ◽

Eshagh Lasemi ◽

Hamidreza Mahaseni Aghdam ◽

Farshid Malihi ◽

◽

...

Keyword(s):

Blood Glucose ◽

Local Anesthetic ◽

Tooth Extraction ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Local Anesthetic Injection

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A Novel Introducer for Ultrasound-Guided Cryoneurolysis Administration to Improve Patient Safety an d Functionality

Pain Management Case Reports ◽

10.36076/pmcr.2020/4/217 ◽

2020 ◽

pp. 217-220

Author(s):

JOhn J. Finneran IV

Keyword(s):

Peripheral Nerve ◽

Postoperative Analgesia ◽

Local Anesthetic ◽

Improve Patient Safety ◽

Femoral Nerve ◽

Needle Insertion ◽

Ultrasound Guided ◽

Needle Pass ◽

Time Required ◽

Local Anesthetic Injection

Background: Percutaneous cryoneurolysis provides prolonged postoperative analgesia by placing a probe adjacent to a peripheral nerve and cooling the probe tip, inducing a reversible block that lasts weeks to months. Unfortunately, freezing the nerve can produce significant pain. Consequently, local anesthetic is generally applied to the nerve prior to cryoneurolysis, which, until now, required an additional needle insertion increasing both the risks and duration of the procedure. Case Presentation: Three patients underwent ultrasound-guided percutaneous cryoneurolysis of either the sciatic and saphenous nerves or the femoral nerve. In all patients, the local anesthetic injection and cryoneurolysis were accomplished with a single needle pass using the novel probe introducer. Conclusion: This introducer allows perineural local anesthetic injection followed immediately by cryoneurolysis, thereby sparing patients a second skin puncture, lowering the risks of the procedure, and decreasing the overall time required for cryoneurolysis. Key words: Cryoablation, cryoanalgesia, peripheral nerve block, postoperative analgesia, ultrasound

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Comparison of Pain Perception Using Conventional Versus Computer-Controlled Intraligamentary Local Anesthetic Injection for Extraction of Primary Molars

Anesthesia Progress ◽

10.2344/anpr-66-01-09 ◽

2019 ◽

Vol 66 (2) ◽

pp. 69-76

Author(s):

Meenu Mittal ◽

Radhika Chopra ◽

Ashok Kumar ◽

Dhirendra Srivastava

Keyword(s):

Heart Rate ◽

Conventional Method ◽

Local Anesthetic ◽

Pain Perception ◽

Controlled Trial ◽

Pain Scale ◽

Primary Molars ◽

Primary Molar ◽

Alternative Means ◽

Computer Controlled

This study was conducted to compare pain perception of intraligamentary anesthesia (ILA) using a computer-controlled local anesthetic delivery system (CCLADS) versus a conventional intraligamentary injection for extraction of primary molars. A randomized controlled trial was designed where 82 children requiring 102 primary molar extractions were given ILA of 2% lidocaine with 1:80,000 epinephrine with either the conventional method or a CCLADS. Pain during injection and extraction was assessed using the Sound, Eye, Motor (SEM) scale and heart rate recording. Faces Pain Scale–Revised (FPS) scores were self-reported by patients. The Mann-Whitney test was used for evaluation of FPS and SEM scores and Student's t test for evaluation of heart rate readings. Heart rate values during injection were found to be higher, but not statistically significantly higher (p = .077), for conventional injection versus CCLADS; however, heart rate values during extraction were significantly higher for the conventional method (p = .009). Both FPS and SEM values were found to be significantly higher for conventional ILA technique (p < .05). ILA can be an effective alternative means of anesthesia for primary molar extractions, and CCLADS devices can make ILA more effective and less painful.

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