Lakshmanan Lakshimi, Ravindran Vignesh
Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India.
Int J Clin Pediatr Dent. 2021 Sep-Oct;14(5):616-620. doi: 10.5005/jp-journals-10005-2032.
Profound local anesthetic delivery promotes successful treatment for children in terms of easing their fear, anxiety, and discomfort during dental procedures. Local anesthetic injections are the utmost anticipated or anxious stimuli in the dental operatory. Precooling the oral mucosa by application of cryotherapy before local anesthetic injections can alter the pain perception in children.
To compare the efficacy of cryotherapy application and 20% benzocaine gel at reducing pain perception during buccal infiltration in pediatric patients.
In this split-mouth study, 30 pediatric patients between 7 years and 10 years of age who needed maxillary buccal infiltration of local anesthetics bilaterally for dental treatment were selected. They received cryotherapy (ice pack) on one quadrant (test group) for 2 minutes and 20% benzocaine topical gel on the contralateral quadrant (control group). A pediatric dentist blinded to the study assessed sound, eye, motor (SEM) scale based on patients' reaction during injection (objective method), and patients were instructed to use a visual analog scale (VAS) to rate their distress during injection (subjective method). Statistical analyses were performed using Wilcoxon and Mann-Whitney tests.
The cryotherapy group had significantly reduced pain scores on the VAS scale (40.66 ± 14.60) when compared with the topical anesthetic gel group (61.33 ± 9.73). The cryotherapy group had reduced pain scores on the SEM scale as well (1.2 ± 0.1) when compared with the topical anesthetic gel group (1.6 ± 0.1), which was not statistically significant.
When compared with topical anesthetic gel, precooling the injection site with cryotherapy is beneficial in reducing pain before local anesthesia injection in pediatric patients.
Cryotherapy application eliminates the fear of pain ascribed to injection of local anesthesia and assists in providing pertinent dental care.
Lakshmanan L, Ravindran V. Efficacy of Cryotherapy Application on the Pain Perception during Intraoral Injection: A Randomized Controlled Trial 2021;14(5):616-620.
深度局部麻醉给药有助于减轻儿童在牙科治疗过程中的恐惧、焦虑和不适，从而促进治疗的成功。局部麻醉注射是牙科治疗中最令人期待或焦虑的刺激因素。在局部麻醉注射前应用冷冻疗法对口腔黏膜进行预冷，可以改变儿童的疼痛感知。
比较冷冻疗法和20%苯佐卡因凝胶在减轻儿科患者颊部浸润麻醉期间疼痛感知方面的效果。
在这项双侧口内对照研究中，选取了30名年龄在7至10岁之间、需要双侧上颌颊部浸润局部麻醉进行牙科治疗的儿科患者。他们在一个象限（试验组）接受2分钟的冷冻疗法（冰袋），在对侧象限（对照组）接受20%苯佐卡因外用凝胶。一位对研究不知情的儿科牙医根据患者注射期间的反应，采用声音、眼神、动作（SEM）量表进行评估（客观方法），并指导患者使用视觉模拟量表（VAS）对注射期间的痛苦程度进行评分（主观方法）。使用Wilcoxon检验和Mann-Whitney检验进行统计分析。
与外用麻醉凝胶组（61.33±9.73）相比，冷冻疗法组的VAS量表疼痛评分显著降低（40.66±14.60）。与外用麻醉凝胶组（1.6±0.1）相比，冷冻疗法组的SEM量表疼痛评分也有所降低（1.2±0.1），但差异无统计学意义。
与外用麻醉凝胶相比，用冷冻疗法对注射部位进行预冷有助于减轻儿科患者局部麻醉注射前的疼痛。
冷冻疗法的应用消除了因局部麻醉注射引起的疼痛恐惧，并有助于提供相关的牙科护理。
Lakshmanan L, Ravindran V. 冷冻疗法对口内注射时疼痛感知的效果：一项随机对照试验[J]. 2021;14(5):616-620.
