Journal of Dental Anesthesia and Pain Medicine

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
권호 표지
DOI QR코드

DOI QR Code

Comparison of anxiety and pain perceived with conventional and computerized local anesthesia delivery systems for different stages of anesthesia delivery in maxillary and mandibular nerve blocks

  • Aggarwal, Kamal (Department of Periodontics, Maulana Azad Institute of Dental Sciences) ;
  • Lamba, Arundeep Kaur (Department of Periodontics, Maulana Azad Institute of Dental Sciences) ;
  • Faraz, Farrukh (Department of Periodontics, Maulana Azad Institute of Dental Sciences) ;
  • Tandon, Shruti (Department of Periodontics, Maulana Azad Institute of Dental Sciences) ;
  • Makker, Kanika (Department of Periodontics, Maulana Azad Institute of Dental Sciences)
  • Received : 2018.10.09
  • Accepted : 2018.11.26
  • Published : 2018.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Fear of local anesthesia (LA) is a significant impediment to dental care as many patients delay or avoid treatment to avert pain. Computer-controlled local anesthetic delivery system (CCLAD), with constant and controlled rate of flow, present a painless alternative. The present study aimed to compare anxiety and pain perceived with conventional and computerized systems, for different stages of anesthesia delivery when administering various nerve blocks. Methods: One hundred patients requiring bilateral LA participated in the study. One side was anesthetized using one system and the contralateral side was anesthetized using the other, in two separate appointments. Patients assigned anxiety scores on a 5-point scale and used the visual analogue scale (VAS) for pain determination at needle insertion, during delivery of anesthetic solution, immediately after injection, and at the end of the periodontal procedure. Each patient's preference for the delivery system of future injections was also recorded. Results: Patients reported significantly lower anxiety levels with CCLAD compared to the syringe. Significantly lower mean VAS scores for anesthesia deposition, pain immediately after, and at the end of the periodontal procedure were also noted. However, pain at needle insertion was comparable between the two systems, with no statistical significance. Overall, 64.4% patients preferred CCLAD for future anesthesia. Conclusion: Lower pain perceived with CCLAD and higher preference for the system suggest that CCLAD should replace conventional syringes to allow pain-free dental treatment.

Keywords

References

  1. Locker D, Sharpiro D, Lidell A. Who is dentally anxious? Concordance between measures of dental anxiety. Community Dent Oral Epidemiol 1996; 24: 346-50. https://doi.org/10.1111/j.1600-0528.1996.tb00874.x
  2. Meechan JG, Howlett PC, Smith BD. Factors influencing the discomfort of intraoral needle penetration. Anesth Prog 2005; 52: 91-4. https://doi.org/10.2344/0003-3006(2005)52[91:FITDOI]2.0.CO;2
  3. Friedman MJ, Hochman MN. A 21st century computerized injection system for local pain control. Compend Contin Educ Dent 1997; 18: 995-1003.
  4. Palm AM, Kirkegaard U, Poulsen S. The wand versus traditional injection for mandibular nerve block in children and adolescents: Perceived pain and time of onset. Pediatr Dent 2004; 26: 481-4.
  5. Kandiah P, Tahmassebi JF. Comparing the onset of maxillary infiltration local anaesthesia and pain experience using the conventional technique vs. the Wand in children. Br Dent J 2012; 213: E15. https://doi.org/10.1038/sj.bdj.2012.988
  6. Krochak M, Friedman N. Using a precision metered injection system to minimize dental injection anxiety. Compend Contin Educ Dent 1998; 19: 137-48.
  7. Katz J, Melzack R. Measurement of pain. Surg Clin North Am 1999; 79: 231-52. https://doi.org/10.1016/S0039-6109(05)70381-9
  8. Malamed SF. Handbook of local anesthesia. 4th ed. St. Louis: Mosby; 1997. pp 191-218.
  9. Goodell GG, Gallagher FJ, Nicoll BK. Comparison of a controlled injection pressure system with a conventional technique. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000; 90: 88-94. https://doi.org/10.1067/moe.2000.107365
  10. Tahmassebi JF, Nikolaou M, Duggal MS. A comparison of pain and anxiety associated with the administration of maxillary local analgesia with Wand and conventional technique. Eur Arch of Paediat Dent 2009; 10:77-82. https://doi.org/10.1007/BF03321604
  11. Yenisey M. Comparison of the pain levels of computercontrolled and conventional anesthesia techniques in prosthodontic treatment. J Appl Oral Sci 2009; 17: 414-20. https://doi.org/10.1590/S1678-77572009000500012
  12. Yesilyurt C, Bulut G, Tasdemir T. Pain perception during inferior alveolar injection administered with the Wand or conventional syringe. Br Dent J 2008; 10: 258-9.
  13. Nusstein J, Lee S, Reader A, Beck M, Weaver J. Anesthetic efficacy of the anterior middle superior alveolar injection. Anesth Prog 2004; 51: 80-9.
  14. Asarch T, Allen K, Petersen B, Beiraghi S. Efficacy of a computerized local anesthesia device in pediatric dentistry. Pediatr Dent 1999; 21: 421-4.
  15. Gibson RS, Allen K, Hutfless S, Beiraghi S. The Wand vs. traditional injection: a comparison of pain related behaviors. Pediatr Dent 2000; 22: 458-62.
  16. Allen KD, Kotil D, Larzelere RE, Hutfless S, Beiraghi S. Comparison of a computerized anesthesia device with a traditional syringe in preschool children.Pediatr Dent 2002; 24: 315-20.
  17. Fukayama H, Yoshikawa F, Kohase H, Umino M, Suzuki N. Efficacy of anterior and middle superior alveolar (AMSA) anesthesia using a new injection system: the Wand. Quintessence Int 2003; 34: 537-41.
  18. Palm AM, Kirkegaard U, Poulsen S. The wand versus traditional injection for mandibular nerve block in children and adolescents; perceived pain and time of onset. Pediatr Dent 2004; 26; 481-4.
  19. Nicholson JW, Berry TG, Summitt JB, Yuan CH, Witten TM. Pain perception and utility: a comparison of the syringe and computerized local injection techniques. Gen Dent 2001; 49: 167-73.
  20. Hochman M, Chiarello D, Hochman CB, Lopatkin R, Pergola S. Computerized local anesthetic delivery vs. traditional syringe technique: subjective pain response. NY State Dent J 1997; 63: 24-9.
  21. Loomer PM, Perry DA. Computer-controlled delivery versus syringe delivery of local anesthetic injections for theurapeutic scaling and root planing. J Am Dent Assoc 2004; 135: 358-65. https://doi.org/10.14219/jada.archive.2004.0188
  22. Price DD, Bush FM, Long S, Harkins SW. A comparison of pain measurement characteristics of mechanical visual analogue and simple numerical rating scales. Pain 1994; 56: 217-26. https://doi.org/10.1016/0304-3959(94)90097-3

Cited by

  1. Patient evaluations after local anesthesia with a computer-assisted method and a conventional syringe before and after reflection time: A prospective randomized controlled trial vol.7, pp.2, 2018, https://doi.org/10.1016/j.heliyon.2021.e06012
  2. Prospective observational study of the impact of plasma colistin levels in patients with carbapenem-resistant Acinetobacter baumannii pneumonia vol.27, pp.None, 2018, https://doi.org/10.1016/j.jgar.2021.10.017