N Sneharaj, Sharma Akhilesh, Siddaiah Madhusudhan Kempaiah, Subramaniam Priya
Department of Pediatric and Preventive Dentistry, The Oxford Dental College, Bengaluru, India.
J Dent Anesth Pain Med. 2024 Apr;24(2):101-108. doi: 10.17245/jdapm.2024.24.2.101. Epub 2024 Mar 28.
Administering anesthesia in dentistry can be distressing for patients, especially those with dental fear and anxiety. Needle pain during local anesthesia is a common concern in intraoral procedures. This study aimed to compare pain perception in 4-6-year-old children following intraoral dental injections with 26- and 31-gauge needles.
Fifty healthy children were divided according to age into Group I (N = 25; 4-5 years) and Group II (N = 25; 5-6 years). Each group was further subdivided according to the needle gauge as follows: Group IA (26 gauge), Group IB (31 gauge), Group IIA (26 gauge), and Group IIB (31 gauge). Using a lottery method, the gauge of the needle to be used at the first visit for local anesthesia administration was selected. Children's reactions to pain were evaluated using a Modified Behavioral Pain Scale. Immediately after administration of local anesthesia, pain perception was evaluated using the Faces pain rating scale. In the subsequent visit, another needle gauge was used to administer local anesthesia, and the previously described evaluations were performed. At the third appointment, the child was shown both syringes and asked to choose one of the syringes they preferred, and the choice was noted.
When local anesthesia was administered using a 31-gauge needle, pain perception was similar between the two groups. In group II, the children demonstrated significantly higher arm and leg movements (P = 0.001). However, the difference was significant in group I alone (P < 0.001).
Irrespective of age, anesthesia with a 31-gauge needle resulted in significantly lower pain perception than anesthesia with a 26-gauge needle.
在牙科实施麻醉可能会让患者感到痛苦,尤其是那些有牙科恐惧和焦虑的患者。局部麻醉期间的注射疼痛是口腔内操作中常见的问题。本研究旨在比较4至6岁儿童在口腔内进行牙科注射时使用26号和31号针头后的疼痛感知。
50名健康儿童按年龄分为I组(N = 25;4至5岁)和II组(N = 25;5至6岁)。每组再根据针头规格进一步细分如下:IA组(26号)、IB组(31号)、IIA组(26号)和IIB组(31号)。采用抽签法选择首次局部麻醉时使用的针头规格。使用改良行为疼痛量表评估儿童对疼痛的反应。在局部麻醉给药后立即使用面部疼痛评分量表评估疼痛感知。在随后的就诊中,使用另一种针头规格进行局部麻醉,并进行上述评估。在第三次就诊时,向儿童展示两个注射器,并要求他们选择一个更喜欢的注射器,并记录选择结果。
当使用31号针头进行局部麻醉时,两组之间的疼痛感知相似。在II组中,儿童的手臂和腿部运动明显更多(P = 0.001)。然而,仅在I组中差异显著(P < 0.001)。
无论年龄大小,使用31号针头麻醉比使用26号针头麻醉导致的疼痛感知显著更低。