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眼动脱敏再处理疗法作为儿童拔牙疼痛管理辅助手段的随机对照试验

Eye movement desensitization and reprocessing therapy as an adjunct to pain management during dental extraction in children - a randomized control trial.

作者信息

Rathore Apoorva, Kalra Namita, Tyagi Rishi, Khatri Amit, Srivastava Shruti, Khandelwal Deepak

机构信息

Department of Pediatrics and Preventive Dentistry, University College of Medical Sciences, Guru Teg Bahadur Hospital (University of Delhi), Delhi, India.

Department of Psychiatry, University College of Medical Sciences, Guru Teg Bahadur Hospital (University of Delhi), Delhi, India.

出版信息

J Dent Anesth Pain Med. 2024 Oct;24(5):329-340. doi: 10.17245/jdapm.2024.24.5.329. Epub 2024 Sep 26.

Abstract

BACKGROUND

Dental treatment is challenging for children experiencing pain and anxiety. Effective administration of local anesthesia (LA) is crucial for most pediatric dentistry treatments. Eye Movement Desensitization and Reprocessing (EMDR) therapy has emerged primarily to manage post-traumatic stress disorder (PTSD) and a wide variety of anxiety- and pain-related conditions. However, the use of this therapy to manage pain in pediatric dentistry has not yet been reported. This study aimed to assess the trends in pain in pediatric dental patients with and without EMDR therapy during LA and extraction. The need for analgesic consumption within 24 h post extraction and the overall dental experience were also evaluated.

METHODS

Sixty children aged 8-12 years participated in a randomized controlled clinical trial with the goal of extracting the primary mandibular first or second molar on the right or left side and were stratified into: group I: EMDR therapy; group II: Tender Love and Care. Pain was measured at three different time intervals. An unpaired t-test was performed for intergroup comparison of continuous data, and the repeated measures ANOVA was applied for intergroup comparison between the groups.

RESULTS

Pain was significantly lower in group I (pain after topical LA gel application, P = 0.229; pain after LA administration, P = 0.036; pain after extraction, P < 0.001). The need for analgesic consumption was lower in this group (P = 0.072), and the overall dental experience was rated better (P < 0.0001).

CONCLUSION

Research has shown that EMDR therapy effectively reduces pain in children, making it a recommended practice for pediatric dentists trained in this technique.

摘要

背景

对于经历疼痛和焦虑的儿童而言,牙科治疗颇具挑战性。有效实施局部麻醉(LA)对大多数儿童牙科治疗至关重要。眼动脱敏再处理(EMDR)疗法主要用于治疗创伤后应激障碍(PTSD)以及各种与焦虑和疼痛相关的病症。然而,该疗法在儿童牙科疼痛管理中的应用尚未见报道。本研究旨在评估在局部麻醉和拔牙过程中,接受和未接受眼动脱敏再处理(EMDR)疗法的儿童牙科患者的疼痛趋势。同时还评估了拔牙后24小时内的镇痛药物使用需求以及总体牙科体验。

方法

60名8至12岁的儿童参与了一项随机对照临床试验,目的是拔除右侧或左侧的下颌第一或第二乳磨牙,并被分为:第一组:眼动脱敏再处理(EMDR)疗法组;第二组:关爱护理组。在三个不同时间间隔测量疼痛程度。对连续数据进行组间比较时采用独立样本t检验,对组间进行组间比较时采用重复测量方差分析。

结果

第一组的疼痛明显更低(局部应用利多卡因凝胶后的疼痛,P = 0.229;局部麻醉给药后的疼痛,P = 0.036;拔牙后的疼痛,P < 0.001)。该组的镇痛药物使用需求更低(P = 0.072),总体牙科体验评分更高(P < 0.0001)。

结论

研究表明,眼动脱敏再处理(EMDR)疗法能有效减轻儿童的疼痛,使其成为接受过该技术培训的儿童牙医的推荐治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7bc/11471346/e65f5fc73c09/jdapm-24-329-g001.jpg

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