Flisfisch Sohar, Woelber Johan Peter, Walther Winfried
University Medical Center Freiburg, Center for Dental Medicine, Department of Operative Dentistry and Periodontology, Private Practice, Steinengraben 67, CH - 4051 Basel, Switzerland.
University Medical Center Freiburg, Center for Dental Medicine, Department of Operative Dentistry and Periodontology, Klinik für Zahnerhaltungskunde und Parodontologie, Hugstetter Strasse 55, D - 79106 Freiburg, Germany.
Heliyon. 2021 Feb 8;7(2):e06012. doi: 10.1016/j.heliyon.2021.e06012. eCollection 2021 Feb.
This prospective randomized controlled trial aimed to evaluate and compare patient response to a conventional syringe and a computer-controlled local anesthetic delivery system (CCLAD) both immediately and after reflection time, including the impact of anesthesia duration.
Twenty adult patients (10 men and 10 women) with at least two tooth-neck defects each in different quadrants were treated with local buccal infiltration anesthesia. Using split-mouth design, one quadrant was anesthetized using a conventional syringe, the other with CCLAD. The time elapsed between time of injection and time of disappearance of numbness was recorded. Patients were asked to mark on a Visual Analog Scale their visual impression of the device regarding anxiety-inducement, their sensation of mucosal puncture, pain during administration, and pain perception during treatment for the two different methods as well as future preference immediately after treatment and after reflection time.
The level of anxiety-inducement and pain during administration were ranked three times higher with the conventional syringe (35.95%-11.85%, p < 0.001 and 21.3%-7.7%, p = 0.005, respectively). There was no difference in mean sensation of mucosal puncture, nor a statistically significant correlation between duration of administration and time until disappearance of numbness. Once anesthesia was administered, no pain during treatment was detected using either method. Patients' preference of methods changed significantly with time in favor of CCLAD (p = 0.01).
The use of CCLAD increased patients' comfort visually and in terms of administration; patients' preference in favor of CCLAD increased with time.
Patients' preference of CCLAD over against the conventional syringe, even more so after reflection time, can imply the preference of CCLAD for clinicians, too, in order to enhance patients' and clinicians' comfort.
这项前瞻性随机对照试验旨在评估和比较患者在即刻及经过思考时间后对传统注射器和计算机控制局部麻醉给药系统（CCLAD）的反应，包括麻醉持续时间的影响。
20名成年患者（10名男性和10名女性），每个患者在不同象限至少有两个牙颈部缺损，接受局部颊侧浸润麻醉。采用双侧对照设计，一个象限使用传统注射器进行麻醉，另一个象限使用CCLAD进行麻醉。记录注射时间与麻木消失时间之间的间隔。要求患者在视觉模拟量表上标记他们对两种不同方法的焦虑诱导、黏膜穿刺感觉、给药过程中的疼痛以及治疗过程中的疼痛感知的视觉印象，以及治疗后即刻和经过思考时间后的未来偏好。
传统注射器的焦虑诱导水平和给药过程中的疼痛程度分别高出三倍（分别为35.95%-11.85%，p<0.001和21.3%-7.7%，p = 0.005）。黏膜穿刺的平均感觉没有差异，给药持续时间与麻木消失时间之间也没有统计学上的显著相关性。一旦给予麻醉，两种方法在治疗过程中均未检测到疼痛。患者对方法的偏好随时间显著变化，更倾向于CCLAD（p = 0.01）。
CCLAD的使用在视觉上和给药方面提高了患者的舒适度；患者对CCLAD的偏好随时间增加。
患者对CCLAD的偏好超过传统注射器，尤其是在经过思考时间后，这也可能意味着临床医生也更倾向于使用CCLAD，以提高患者和临床医生的舒适度。
