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不同局部牙科麻醉技术对 9-12 岁儿童的影响:疼痛和焦虑的随机临床试验。

The influence of distinct techniques of local dental anesthesia in 9- to 12-year-old children: randomized clinical trial on pain and anxiety.

机构信息

Dental PostGraduate Program, State University of Ponta Grossa, Rua Carlos Cavalcanti, 4748, Bloco M - Uvaranas, Paraná, Ponta Grossa, Brazil.

Dental Undergraduate Program, State University of Ponta Grossa, Rua Carlos Cavalcanti, 4748, Bloco M - Uvaranas, Paraná, Ponta Grossa, Brazil.

出版信息

Clin Oral Investig. 2021 Jun;25(6):3831-3843. doi: 10.1007/s00784-020-03713-7. Epub 2021 Mar 14.

Abstract

OBJECTIVES

To evaluate pain, disruptive behavior, and anxiety in children undergoing different local dental anesthetic techniques.

METHODS

This randomized/parallel clinical trial analyzed three groups of patients (9-12 years old) (n = 35) who received infiltrative anesthesia using conventional (CA), vibrational (VBA), and computer-controlled techniques (CCLAD). The outcomes were pain self-perception (Wong-Baker Faces Pain Rating Scale (WBF); Numerical Ranting Scale (NRS)), disruptive behavior (Face, Legg, Activity, Crying, Consolability Scale (FLACC)), anxiety (Corah's Dental Anxiety Scale; modified Venham Picture test (VPTm)), and physiological parameters (systolic (SBP)/diastolic pressure (DBP); heart rate (HR); oxygen saturation (SpO2); respiratory rate (RR)). Statistical analysis was accomplished using Kruskall-Wallis test and ANOVA for repeated measures (α = 0.05).

RESULTS

Dental anxiety levels at the baseline were similar for all patients. CA promoted less pain than VBA in WBF (p = 0.018) and NRS (p = 0.006) and CCLAD in WBF (p = 0.029). There were no differences in disruptive behavior (FLACC p = 0.573), anxiety (VPTm p = 0.474), blood pressure (SBP p = 0.954; DBP p = 0.899), heart rate (p = 0.726), oxygen saturation (p = 0.477), and respiratory rate (p = 0.930) between anesthetic techniques.

CONCLUSION

Conventional technique resulted in less pain perception for dental local anesthesia.

CLINICAL RELEVANCE

Conventional technique reduces the self-reported pain in children 9-12 years old, and therefore, the use of additional devices or different anesthetic techniques is not justified.

摘要

目的

评估接受不同局部牙科麻醉技术的儿童的疼痛、行为障碍和焦虑情况。

方法

本随机/平行临床试验分析了三组(9-12 岁)(n=35)接受常规浸润麻醉(CA)、振动(VBA)和计算机控制技术(CCLAD)的患者。结果是疼痛自我感知(Wong-Baker 面部疼痛评分量表(WBF);数字评分量表(NRS))、行为障碍(面部、腿部、活动、哭泣、安抚性量表(FLACC))、焦虑(Corah 的牙科焦虑量表;改良 Venham 图片测试(VPTm))和生理参数(收缩压(SBP)/舒张压(DBP);心率(HR);血氧饱和度(SpO2);呼吸频率(RR))。使用 Kruskal-Wallis 检验和重复测量的方差分析(α=0.05)进行统计分析。

结果

所有患者的基线牙科焦虑水平相似。CA 在 WBF(p=0.018)和 NRS(p=0.006)中比 VBA 引起的疼痛更少,在 CCLAD 中在 WBF 中引起的疼痛更少(p=0.029)。行为障碍(FLACC p=0.573)、焦虑(VPTm p=0.474)、血压(SBP p=0.954;DBP p=0.899)、心率(p=0.726)、血氧饱和度(p=0.477)和呼吸频率(p=0.930)在麻醉技术之间无差异。

结论

常规技术可减少儿童局部麻醉的疼痛感知。

临床相关性

常规技术可减少 9-12 岁儿童的自我报告疼痛,因此,使用额外的设备或不同的麻醉技术是没有道理的。

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