Aggarwal Kamal, Lamba Arundeep Kaur, Faraz Farrukh, Tandon Shruti, Makker Kanika
Department of Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, Delhi, India.
J Dent Anesth Pain Med. 2018 Dec;18(6):367-373. doi: 10.17245/jdapm.2018.18.6.367. Epub 2018 Dec 28.
Fear of local anesthesia (LA) is a significant impediment to dental care as many patients delay or avoid treatment to avert pain. Computer-controlled local anesthetic delivery system (CCLAD), with constant and controlled rate of flow, present a painless alternative. The present study aimed to compare anxiety and pain perceived with conventional and computerized systems, for different stages of anesthesia delivery when administering various nerve blocks.
One hundred patients requiring bilateral LA participated in the study. One side was anesthetized using one system and the contralateral side was anesthetized using the other, in two separate appointments. Patients assigned anxiety scores on a 5-point scale and used the visual analogue scale (VAS) for pain determination at needle insertion, during delivery of anesthetic solution, immediately after injection, and at the end of the periodontal procedure. Each patient's preference for the delivery system of future injections was also recorded.
Patients reported significantly lower anxiety levels with CCLAD compared to the syringe. Significantly lower mean VAS scores for anesthesia deposition, pain immediately after, and at the end of the periodontal procedure were also noted. However, pain at needle insertion was comparable between the two systems, with no statistical significance. Overall, 64.4% patients preferred CCLAD for future anesthesia.
Lower pain perceived with CCLAD and higher preference for the system suggest that CCLAD should replace conventional syringes to allow pain-free dental treatment.
对局部麻醉的恐惧是牙科治疗的一个重大障碍,因为许多患者会推迟或避免治疗以避免疼痛。计算机控制局部麻醉给药系统(CCLAD)具有恒定且可控的流速,是一种无痛替代方案。本研究旨在比较在进行各种神经阻滞时,传统系统和计算机化系统在麻醉给药不同阶段所带来的焦虑和疼痛感受。
一百名需要双侧局部麻醉的患者参与了该研究。在两次单独的就诊中,一侧使用一种系统进行麻醉,另一侧使用另一种系统进行麻醉。患者用5分制对焦虑程度进行评分,并在针头插入时、麻醉剂溶液注射期间、注射后立即以及牙周治疗结束时使用视觉模拟量表(VAS)来确定疼痛程度。还记录了每位患者对未来注射给药系统的偏好。
与注射器相比,患者报告使用CCLAD时焦虑水平显著更低。在麻醉剂注入、注射后立即以及牙周治疗结束时,平均VAS评分也显著更低。然而,两种系统在针头插入时的疼痛程度相当,无统计学意义。总体而言,64.4%的患者更倾向于在未来麻醉时使用CCLAD。
CCLAD带来的疼痛更低且患者对该系统的偏好更高,这表明CCLAD应取代传统注射器以实现无痛牙科治疗。