Sucrose solution for alleviating needle pain during inferior alveolar nerve block in children aged 7–10 years: a randomized clinical trial

Background@#Intraoral local anesthesia is essential for delivering dental care; however, injection of this local anesthetic is perceived as the most painful and distressing agent for children, parents, and healthcare providers.Reducing pain as much as possible is essential to ensure smooth subsequent treatment procedures, especially in pediatric dentistry. In clinical practice, oral sucrose administration has been reported to decrease the pain during heel lance and cold pressor tests in neonates and children. This study aimed to determine whether the prior administration of a 30% sucrose solution reduced the pain related to inferior alveolar nerve block in children. @*Methods@#A total of 42 healthy children aged 7–10 years requiring dental treatment of mandibular molars involving inferior alveolar nerve block were recruited. The participants’ demographic details were recorded, height and weight were measured, and the anesthetic injection was delivered after receiving the respective intraoral sucrose solution and distilled water by the intervention (group 1) and control (group 2) group participants for 2 min.The subjective pain perceived during injection was measured using an animated emoji scale. The pain scores between the groups were compared using the Mann–Whitney U test. @*Results@#The median pain score and range for the intervention and control groups were 4 (2 – 6) and 6 (4 – 8), respectively, and statistically significant differences (P < 0.001) were observed in the intervention group.Age, sex, height, and weight did not influence the analgesic effect of the sucrose solution. @*Conclusion@#Oral administration of sucrose may relieve pain associated with inferior alveolar nerve block in children.

Comparative efficacy of three topical anesthetics on 7-11-year-old children: a randomized clinical study

BACKGROUND: This study evaluated the efficacy of three intraoral topical anesthetics in reducing the injection needle prick pain from local anesthetic among children aged 7–11 years old.METHODS: It is a prospective, Interventional, parallel design, single-blind, randomized clinical trial in which subjects (n=90) aged 7–11 years were included in the study based on an inclusion criteria. Subjects were divided into three groups based on computer-generated randomization with an allocation ratio of 1:1:1. Groups A, B, and C received benzocaine 20% jelly (Mucopain gel, ICPA health products Ltd, Ankleshwar, India), cetacaine anesthetic liquid (Cetylite Industries, Inc, Pennsauken, NJ), and EMLA cream (2% AstraZeneca UK Ltd, Luton, UK), respectively, according to manufacturer's instructions, for 1 minute prior to local anesthetic injection. After application of topical anesthetic agent, for all the groups, baseline pre-operative (prior to topical anesthetic administration) and post-operative scores (after local anesthetic administration) of pulse rate was recorded using Pulse oximeter (Gibson, Fingertip Pulse Oximeter, MD300C29, Beijing Choice Electronic). Peri-operative (i.e., during the administration of local anesthesia) scores were recorded using Face, Legs, Activity, Cry, Consolability (FLACC) Scale, Modified Children hospital of Eastern Ontario Pain Scale (CPS) behavior rating scale, and Faces Pain Scale (FPS-R) – Revised (For self-reported pain). Direct self-reported and physiological measures were ascertained using FPS-R – Revised and Pulse oximeter, respectively, whereas CPS and FLACC scales assessed behavioral measures. To test the mean difference between the three groups, a one way ANOVA with post hoc tests was used. For statistical significance, a two-tailed probability value of P < 0.05 was considered as significant.RESULTS: The Cetacaine group had significantly lower pain scores for self-report (P < 0.001), behavioral, and physiological measures (P < 0.001) than the other two groups. However, there was no significant difference between the Benzocaine group and EMLA group during palatal injection prick.CONCLUSION: Cetacaine can be considered as an effective topical anesthetic agent compared to benzocaine 20% jelly (Mucopain gel) and EMLA cream.

The effect of pre-cooling versus topical anesthesia on pain perception during palatal injections in children aged 7-9 years: a randomized split-mouth crossover clinical trial

Background@#To compare pain perception during palatal injection administration in children aged 7-9 years while using pre-cooling of the injection site versus application of topical anesthesia as a pre-injection anesthetic during the six months.Method: A prospective randomized split-mouth crossover trial was conducted among 30 children aged 7-9 years, who received topical application of either a pencil of ice (test group) or 5% lignocaine gel (control group) for 2 min before injection. The primary and secondary outcome measures were pain perception and child satisfaction, measured by the composite pain score and the faces rating scale, respectively. Unpaired t-test was performed to determine significant differences between groups. @*Results@#The test group had significantly lower pain scores for self-report and behavioral measures (P < 0.0001). The changes in physiological parameters at the baseline (P = 0.74) during (P = 0.37) and after (P = 0.88) the injection prick were not statistically significant. Children felt better by the pre-cooling method (P < 0.0001). @*Conclusion@#Ice application using a pencil of ice for 2 min reduced pain perception significantly compared to the use of a topical anesthetic. Moreover, ice application was preferred by children.

The effect of pre-cooling versus topical anesthesia on pain perception during palatal injections in children aged 7-9 years: a randomized split-mouth crossover clinical trial

Background@#To compare pain perception during palatal injection administration in children aged 7-9 years while using pre-cooling of the injection site versus application of topical anesthesia as a pre-injection anesthetic during the six months.Method: A prospective randomized split-mouth crossover trial was conducted among 30 children aged 7-9 years, who received topical application of either a pencil of ice (test group) or 5% lignocaine gel (control group) for 2 min before injection. The primary and secondary outcome measures were pain perception and child satisfaction, measured by the composite pain score and the faces rating scale, respectively. Unpaired t-test was performed to determine significant differences between groups. @*Results@#The test group had significantly lower pain scores for self-report and behavioral measures (P < 0.0001). The changes in physiological parameters at the baseline (P = 0.74) during (P = 0.37) and after (P = 0.88) the injection prick were not statistically significant. Children felt better by the pre-cooling method (P < 0.0001). @*Conclusion@#Ice application using a pencil of ice for 2 min reduced pain perception significantly compared to the use of a topical anesthetic. Moreover, ice application was preferred by children.