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 blocks원문보기
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)
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 aim...
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.
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.
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문제 정의
However, administration of LA injection produces anxiety and pain in patients. Therefore, research has continued to develop new and better ways of delivering adequate LA to improve patient comfort. CCLAD was developed with this same aim.
제안 방법
The present study was undertaken to evaluate pain and anxiety associated with conventional syringe and CCLAD for nerve block LA, administered for periodontal procedures. In particular, this study compared pain associated with the two techniques during different phases of local anesthetic delivery (at needle insertion, during deposition of anesthesia, immediately after deposition, and at the end of the periodontal procedure).
One limitation of this study was the inability to implement a double -blinded research design. Blinding is not possible, because the operator would always be aware of the significant difference between the two injection systems during LA administration.
CCLAD or conventional syringe was randomly selected and used to deliver LA to one side of the arch. The patient was asked to rate the associated pain on VAS at the following stages: during needle insertion, during delivery of anesthetic solution, and immediately after the injection. Pain was also assessed at the completion of the periodontal procedure.
대상 데이터
One hundred adults (44 males and 56 females) with a mean age of 34.15 ± 18.92 years were selected from the Outpatient Department of Periodontology, Maulana Azad Institute of Dental Sciences according to the inclusion and exclusion criteria and enrolled in the study.
This is a prospective randomized split-mouth study. Patients aged 18-65 years with periodontal disease, requiring bilateral LA in the same arch, were recruited for the study. Patients who are allergic to LA or any of its components, medically compromised, smoking, pregnant, lactating, or taking corticosteroids or nonsteroidal anti-inflammatory drugs were not included.
데이터처리
0. Mann-Whitney U tests were used to compare the anxiety and VAS scores obtained from the patients. The significance level was set as 5%.
이론/모형
1. The visual analogue scale (VAS) used for evaluating the perceived pain among patients.
성능/효과
In conclusion, the results of the present study demonstrated the advantages of CCLAD over the conventional syringe for delivering LA, as evidenced by the significantly lower anxiety and perceived pain among patients, as well as higher preference for CCLAD. Further studies using objective physiological markers of pain, such as changes in heart rate and blood pressure, may be useful for confirming the findings of this study.
Lastly, pain reported at the completion of periodontal procedures was also lower in CCLAD, and this difference was statistically significant (1.78 ± 4.51 with conventional syringe; 0.96 ± 4.71 with CCLAD; P = 0.011) (Table 3).
The mean anxiety scores with conventional syringe and CCLAD were 1.01 ± 1.02 and 0.78 ± 0.91, respectively, indicating a significantly lower anxiety level in the CCLAD group (P = 0.043) (Fig. 3).
후속연구
In conclusion, the results of the present study demonstrated the advantages of CCLAD over the conventional syringe for delivering LA, as evidenced by the significantly lower anxiety and perceived pain among patients, as well as higher preference for CCLAD. Further studies using objective physiological markers of pain, such as changes in heart rate and blood pressure, may be useful for confirming the findings of this study.
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