Goyal Saumya, Patel Megha, Bhatt Rohan, Vaghela Lilavanti, Vadher Rupal, Choksi Kaksha
Department of Pediatric and Preventive Dentistry, Karnavati School of Dentistry, Surat, Gujarat, India.
Department of Pediatric and Preventive Dentistry, Karnavati School of Dentistry, Gandhinagar, Gujarat, India.
Int J Clin Pediatr Dent. 2024 Nov;17(11):1265-1271. doi: 10.5005/jp-journals-10005-2956. Epub 2024 Dec 19.
When it comes to reducing children's fear, anxiety, and discomfort during dental procedures, substantial local anesthetic delivery promotes adequate intervention. In the dental operatory, local anesthetic injections are the most anticipated or feared stimuli. The application of topical anesthetics, cryotherapy, and transcutaneous electrical nerve stimulation (TENS) to the oral mucosa prior to local anesthetic injections can alter pain perception in children.
To compare the efficacy of cryotherapy application, 2% benzocaine gel, and TENS therapy at reducing pain perception during local anesthesia (LA) administration in pediatric patients.
In this randomized clinical trial, 75 pediatric patients between 4 and 8 years of age who needed LA for dental treatment were selected. They received cryotherapy (EXOCOOL) externally, 2% lignocaine topical gel (intraorally), or TENS therapy extraorally on the area of treatment. A pediatric dentist blinded to the study assessed Faces, Legs, Activity, Cry, and Consolability (FLACC) (subjective method), pulse rate, and SpO and patients were instructed to use a visual analog scale (VAS) to rate their distress during injection and Venham's Picture Test for anxiety assessment. Statistical analyses were performed using the Wilcoxon and Mann-Whitney tests.
The EXOCOOL group had significantly reduced pain scores on the VAS scale (3.80) when compared with the topical anesthetic gel group (4.08). The TENS group had reduced pain scores on the FLACC scale as well (2.84) when compared with the topical anesthetic gel group (3.72), which was statistically significant ( = 0.003).
According to our study on pain and anxiety alleviation in children during LA administration, we found that TENS therapy demonstrated the highest effectiveness, surpassing both EXOCOOL and LA gel in providing relief.
Goyal S, Patel M, Bhatt R, et al. Comparative Evaluation of Different Pain-alleviating Methods on Child's Dental Anxiety and Pain Perception during Local Anesthesia Administration: A Clinical Study. Int J Clin Pediatr Dent 2024;17(11):1265-1271.
在减少牙科治疗过程中儿童的恐惧、焦虑和不适方面，足量的局部麻醉给药有助于进行充分的干预。在牙科诊疗室，局部麻醉注射是最令人期待或恐惧的刺激。在局部麻醉注射前，将局部麻醉剂、冷冻疗法和经皮电刺激神经疗法（TENS）应用于口腔黏膜，可以改变儿童的疼痛感知。
比较冷冻疗法、2%苯佐卡因凝胶和TENS疗法在减轻儿科患者局部麻醉（LA）给药期间疼痛感知方面的疗效。
在这项随机临床试验中，选取了75名4至8岁需要进行牙科治疗局部麻醉的儿科患者。他们在治疗区域接受了外部冷冻疗法（EXOCOOL）、2%利多卡因局部凝胶（口腔内）或TENS疗法（口腔外）。一位对研究不知情的儿科牙医评估面部、腿部、活动、哭闹和安慰度（FLACC）（主观方法）、脉搏率和血氧饱和度，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，以及使用韦纳姆图片测试进行焦虑评估。使用威尔科克森检验和曼 - 惠特尼检验进行统计分析。
与局部麻醉凝胶组（4.08）相比，EXOCOOL组在VAS量表上的疼痛评分显著降低（3.80）。与局部麻醉凝胶组（3.72）相比，TENS组在FLACC量表上的疼痛评分也有所降低（2.84），具有统计学意义（P = 0.003）。
根据我们对儿童局部麻醉给药期间疼痛和焦虑缓解情况的研究，我们发现TENS疗法显示出最高的有效性，在缓解疼痛方面超过了EXOCOOL和局部麻醉凝胶。
戈亚尔S、帕特尔M、巴特R等。不同减轻疼痛方法对儿童局部麻醉给药期间牙科焦虑和疼痛感知的比较评估：一项临床研究。《国际临床儿科牙科杂志》2024；17（11）：1265 - 1271。
