Davangere Padmanabh Shital Kiran, Gangurde Vishakha Bhausaheb, Jhamb Vikram, Gori Nasrin
Department of Pediatric and Preventive Dentistry, College of Dental Sciences, At. Amargadh, Tal. Sihor, Dist. Bhavnagar, Gujarat, India.
J Dent Anesth Pain Med. 2024 Feb;24(1):37-45. doi: 10.17245/jdapm.2024.24.1.37. Epub 2024 Feb 1.
The delivery of profound local anesthetics helps children receive successful treatment by reducing fear, anxiety, and discomfort during dental procedures. Local anesthetic injections are the most anticipated stimuli in dental surgery. Children's perceptions of pain can be altered by applying cryotherapy to precool the oral mucosa or by diverting their minds through taste distractions before administering local anesthetic injections. This study aimed to evaluate the efficacy of cryoanesthesia and xylitol sweet-tasting solution at the injection site in 7-10-year-old children.
A total of 42 participants, aged 7-10 years, who underwent dental treatment requiring local anesthesia, were enrolled in the study. The children were randomly divided into three groups. In group I, sterile water was held in the mouth for 2 minutes before anesthetic administration, similar to group II, and in group III, a xylitol sweet-tasting solution was used for 2 minutes before needle insertion. The analysis of pain perception was carried out based on the Visual Analog Scale (VAS) and the Sound, Eyes, and Motor (SEM) scale. For VAS analysis, a one-way analysis of variance (ANOVA) was performed for intergroup comparison, and a post hoc Tukey test was performed for subgroup analysis. For the categorical SEM scale, the Kruskal-Wallis test followed by the post hoc test was performed for intergroup comparison. Where a P value of <0.05 was considered statistically significant at 95% confidence intervals.
Cryoanesthesia significantly reduced pain scores on VAS (4.21 ± 1.42) when compared to those on VAS with xylitol sweet-tasting solution (5.50 ± 1.40) and that with sterile water (6.14 ± 2.47). Intergroup comparison of the VAS scores among the three groups was performed using one-way ANOVA, which demonstrated statistically significant differences (P value <0.026) on the VAS scale. Intergroup comparison of the SEM scale was performed using the Kruskal-Wallis test, followed by post hoc comparison, which exhibited statistically significant differences (P < 0.007) among the three groups for the SEM scale.
Cryoanesthesia demonstrated higher efficacy in reducing injection pain than that exhibited by the xylitol sweet-tasting solution.
深度局部麻醉剂的使用有助于儿童在牙科治疗过程中减少恐惧、焦虑和不适，从而获得成功的治疗。局部麻醉注射是牙科手术中最令人担忧的刺激因素。在进行局部麻醉注射前，通过应用冷冻疗法对口腔黏膜进行预冷或通过味觉分散来转移儿童的注意力，可以改变他们对疼痛的感知。本研究旨在评估冷冻麻醉和木糖醇甜味溶液在7至10岁儿童注射部位的效果。
共有42名年龄在7至10岁、需要进行局部麻醉的牙科治疗参与者纳入本研究。这些儿童被随机分为三组。在第一组中，与第二组一样，在给予麻醉剂前将无菌水含在口中2分钟，在第三组中，在插入针头前使用木糖醇甜味溶液2分钟。基于视觉模拟量表（VAS）和声音、眼睛及动作（SEM）量表进行疼痛感知分析。对于VAS分析，进行组间比较的单因素方差分析（ANOVA），并进行事后Tukey检验进行亚组分析。对于分类的SEM量表，进行组间比较的Kruskal-Wallis检验及事后检验。在95%置信区间，P值<0.05被认为具有统计学意义。
与使用木糖醇甜味溶液（5.50±1.40）和无菌水（6.14±2.47）时的VAS评分相比，冷冻麻醉显著降低了VAS上的疼痛评分（4.21±1.42）。使用单因素方差分析对三组之间的VAS评分进行组间比较，结果显示在VAS量表上存在统计学显著差异（P值<0.026）。使用Kruskal-Wallis检验进行SEM量表的组间比较，随后进行事后比较，结果显示在SEM量表上三组之间存在统计学显著差异（P<0.007）。
冷冻麻醉在减轻注射疼痛方面比木糖醇甜味溶液显示出更高的疗效。
