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Effectiveness of precooling the injection site using tetrafluorethane on pain perception in children
Nithasha N Hameed1, Sharan S Sargod1, Sham S Bhat1
1Department of Pedodontics, Yenepoya Dental College, Mangalore, Karnataka, India.
Insights
Cryoanesthesia with tetrafluorethane spray significantly reduced pain during local anesthesia injections in children compared to topical lidocaine. This novel approach offers a more effective and comfortable pain management solution for pediatric dental procedures.
Area of Science:
- Pediatric Dentistry
- Pain Management
- Anesthesiology
Background:
- Local anesthesia injections are a primary cause of avoidance behavior in children.
- Topical anesthetics are commonly used but have drawbacks like prolonged action and taste issues.
- Cryoanesthesia presents a promising alternative to traditional topical anesthetics.
Purpose of the Study:
- To compare the efficacy of cryoanesthesia (tetrafluorethane) with topical lidocaine spray in reducing injection pain in children.
- To evaluate subjective and objective pain perception during local anesthesia administration.
Main Methods:
- A split-mouth study involving 50 children aged 8-10 years requiring bilateral mandibular anesthesia.
- One side received topical lidocaine spray, the other received cryoanesthetic tetrafluorethane spray before injection.
- Pain was assessed using the Visual Analog Scale (VAS) and the Sound, Eye, and Motor (SEM) scale.
Main Results:
- Subjective pain scores (VAS) were significantly lower with tetrafluorethane compared to lidocaine.
- Objective pain scores (SEM) were lower with tetrafluorethane, though not statistically significant.
- Statistical analysis included paired Wilcoxon signed-rank and Mann-Whitney tests.
Conclusions:
- Precooling with tetrafluorethane spray effectively eliminates pain associated with local anesthesia in children.
- Cryoanesthesia is a superior alternative to topical lidocaine for pain control during pediatric dental injections.
Background:
Injection of local anesthesia is one of the most important reasons for avoidance behavior in children. Applying a topical anesthetic before injection is the most popular way to control pain; however, topical anesthetics have some shortcomings such as longer duration of action, displeasing taste, and spread of the anesthetic agent to noninjection site areas. Cryoanesthesia using refrigerant as a topical anesthesia is being studied as an alternative to overcome the shortcomings of topical anesthetics and has shown promising results.
Materials And Methods:
In this split-mouth design study, 50 children of aged 8-10 years who required bilateral mandibular local anesthesia administration were selected. In the first visit, application of topical anesthetic spray (lidocaine) on one side and during the second appointment cryoanesthetic tetrafluorethane on the other side was used before local anesthetic administration. Patients were asked to report their discomfort and pain using visual analog scale (VAS) (subjective method). Patients' pain perception during injection is assessed by sound, eye, and motor (SEM) scale by the dentist (objective method).
Results:
The results were statistically analyzed using paired Wilcoxon signed-rank test and Mann-Whitney tests. In VAS scale (subjective method), pain scores were significantly lower in tetrafluorethane group when compared with lidocaine group. In SEM scale (objective method), pain scores were lower in tetrafluorethane group when compared with lidocaine group, but it was statistically insignificant.
Conclusion:
Precooling the injection site using refrigerant tetrafluorethane spray has shown to be effective in eliminating pain before local anesthesia administration in children when compared with topical anesthetic lidocaine spray.
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