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A Comparative Study on Pain Perception in Children, After Application of Pre-Cooled and Plain Topical Anaesthetic Gel
Prabhadevi C Maganur1, Atiah Abdulrahman Ghawi2, Ghadi DuhDuh Arishi3
1Division of Pediatric Dentistry, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia.
Insights
Pre-cooling topical anesthetic gel significantly reduced pain perception in children during local anesthetic administration compared to plain gel or an ice pack. This method offers a more effective approach to pediatric pain management.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Child Health
Background:
- Effective pain management is crucial for children undergoing procedures requiring local anesthesia.
- This study investigated pain perception in pediatric patients during local anesthetic administration.
Purpose of the Study:
- To compare the efficacy of pre-cooled topical anesthetic gel versus plain gel and ice pack application in reducing pain during local anesthesia in children.
- To evaluate pain and behavioral responses in pediatric patients.
Main Methods:
- A randomized, single-blinded controlled trial involving 51 children aged 6-12 years.
- Participants were divided into three groups: plain topical gel, pre-cooled topical gel, and ice pack application.
- Pain and behavior were assessed using the Face, Leg, Activity, Cry, Consolability (FLACC) scale, Modified Wong-Baker Scale (WBS), and Frankel Behaviour Rating Scale (FBRS).
Main Results:
- Pre-cooled topical anesthetic gel showed significantly lower pain scores on the Modified Wong-Baker Scale (WBS) compared to plain gel and ice pack.
- The Frankel Behaviour Rating Scale (FBRS) indicated a significant difference in behavior during anesthesia, with the pre-cooled gel group showing the highest median score.
- FLACC scores varied significantly, with the ice pack group exhibiting the highest median scores.
Conclusions:
- Pre-cooled topical anesthetic gel is more effective in reducing pain during local anesthetic administration in children than plain gel or an ice pack.
- This finding suggests an improved method for pediatric pain management during dental and minor surgical procedures.
- Further research may explore optimal cooling temperatures and durations for topical anesthetics.
Abstract:
Background: Effective pain management in children is essential, particularly when administering local anaesthesia. This study was undertaken to compare pain perception in children after application of pre-cooled and plain topical anaesthetic gel during local anaesthetic administration. Methods: A randomised, single-blinded controlled trial was conducted among 51 children between the ages of 6 and 12, visiting the paediatric clinic, Jazan (REC-45/10/1070). Children were allocated into one of the following three groups using a simple randomisation having a 1:1:1 allocation ratio into Group I (n = 17): Plain topical anaesthetic gel, Group II (n = 17): Pre-Cooled topical anaesthetic gel, and Group III (n = 17). An ice pack was applied for a period of 1 min at the injection site. The intensity of pain and the behaviour of the children were assessed using Face, Leg, Activity, Cry, Consolability (FLACC), the Modified Wong-Baker Scale (WBS) and the Frankel Behaviour Rating Scale (FBRS). Results: A significant difference in FBRS scores was observed during anaesthesia, with the highest median score [3 (3,3)] in the pre-cooled topical anaesthetic gel group (p value < 0.001). FLACC scores varied significantly among groups, with the ice pack group [3 (3, 3)] and [4 (4, 5)] showing the highest median score (p value < 0.001). WBS scores also differed significantly between groups (p value < 0.001) with a lower value in the pre-cooled topical gel group [0 (0, 0), 2 (0, 2)]. Conclusions: This study concluded that, the use of a pre-cooled topical anaesthetic gel before LA administration reduced the pain better than that of plain anaesthetic gel and ice pack application at the injection site during infiltration.
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