[논문]Making inferior alveolar nerve block more comfortable via computer-controlled local anesthetic delivery: A prospective clinical study

Gajendragadkar, Kunal; Bhate, Kalyani; Jagtap, Bhagyashree; Santhoshkumar, S.N; Kshirsagar, Kapil; Magoo, Surabhi

doi:10.17245/jdapm.2019.19.3.135

Making inferior alveolar nerve block more comfortable via computer-controlled local anesthetic delivery: A prospective clinical study 원문보기

Journal of dental anesthesia and pain medicine, v.19 no.3, 2019년, pp.135 - 141

Gajendragadkar, Kunal (Department of Oral & Maxillofacial Surgery, Dr. D. Y. Patil Vidyapeeth) , Bhate, Kalyani (Department of Oral & Maxillofacial Surgery, Dr. D. Y. Patil Vidyapeeth) , Jagtap, Bhagyashree (Department of Oral & Maxillofacial Surgery, Dr. D. Y. Patil Vidyapeeth) , Santhoshkumar, S.N (Department of Oral & Maxillofacial Surgery, Dr. D. Y. Patil Vidyapeeth) , Kshirsagar, Kapil (Department of Oral & Maxillofacial Surgery, Dr. D. Y. Patil Vidyapeeth) , Magoo, Surabhi (Department of Oral & Maxillofacial Surgery, Dr. D. Y. Patil Vidyapeeth)

Abstract ▼ AI-Helper

Background: The fear of needle insertion and pain during anesthesia is a source of patient dissatisfaction in dentistry. Inferior alveolar nerve block (IANB) remains the most common type of block and is in itself painful. Computer-controlled local anesthetic delivery (CCLAD) has been proven to reduce the pain associated with injection of anesthetics in various blocks. However, the efficacy of CCLAD for IANB in adults remains unknown. Methods: Sixty-four adult patients requiring bilateral IANB were selected and divided into two groups: group A (50 patients receiving IANB via CCLAD) and group B (50 patients receiving IANB using a conventional cartridge syringe). Pain perception and patient comfort were assessed using the visual analog scale and the 5-point semantic scale, respectively. Results: The pain perception was compared between the two groups using the Mann-Whitney U-test, and the P value was 0.003. The patient comfort was also compared using the same test, and the P value was 0.484. Conclusion: A significant difference was observed in the pain perception of the patients during CCLAD. The patient comfort was grossly equal for both techniques.

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문제 정의

Thus, the purpose of our study was to compare the pain perception and patient comfort between the use of a conventional cartridge syringe and CCLAD in adults requiring IANB for routine oral surgical procedures.

제안 방법

A detailed history-taking was conducted for each patient. The patients were informed of the study details, and a written informed consent was obtained from each patient.
As the split-mouth study design was used, 50 patients requiring bilateral IANBs were divided into the following groups: group A, including 50 patients receiving IANB via CCLAD (WAND, Milestone Dental, CA, USA) and group B, including 50 patients receiving IANB using a conventional cartridge syringe.
In group A, CCLAD was used to perform IANB. The participants were asked to rate their pain using the VAS and comfort level using the semantic scale. In group B, a conventional cartridge syringe was used to perform IANB.
In group B, a conventional cartridge syringe was used to perform IANB. The patients were also asked to rate their pain using the VAS and comfort level using the semantic scale. The VAS was used as it offers an extremely high degree of resolution, thereby allowing the subjects to judge even the slightest of differences precisely [15].
This study was performed using a model that would reduce the bias as much as possible. The same operator administered the anesthetics bilaterally.

대상 데이터

A total of 2,130 patients were screened in a period of 6 months. Nine hundred and forty-two patients required bilateral IANB for various treatments.
After ethical approval, participants fulfilling the inclusion criteria were enrolled in the study. Adult patients (aged above 18 years) requiring bilateral IANB for various surgical procedures and willing to participate in the study were selected. Medically compromised patients, patients allergic to local anesthesia, and mentally challenged patients were excluded from the study.
Fifty patients (age range, 18–75 years; mean age, 36.2 ± 2.02 years) were included in the study.
Thus, the final sample size was 100 IANBs.
Nine hundred and forty-two patients required bilateral IANB for various treatments. Upon receiving information regarding the study, 850 patients were not interested to participate in the study. Thus, the 64 remaining patients were randomly allotted into the two groups using the sequentially numbered opaque sealed envelope (SNOSE) technique.

이론/모형

Qualitative/nominal data were presented as proportions. The chi-square test was used to compare the proportions. The Mann-Whitney U-test was used to compare ordinal/non-parametric data (i.
Upon receiving information regarding the study, 850 patients were not interested to participate in the study. Thus, the 64 remaining patients were randomly allotted into the two groups using the sequentially numbered opaque sealed envelope (SNOSE) technique. However, 14 patients failed to report on the second visit.

성능/효과

This comparative, split-mouth, clinical study was conducted in the Department of Oral and Maxillofacial Surgery of our institute. In this study, 50 patients (age, 18-75 years) requiring bilateral IANBs were selected on the basis of the power of the study (two-sided at 90% power, with an error of 5%); their pain perception and comfort during IANB via CCLAD were assessed. The research protocol was initially submitted to our Institutional Ethics Committee and Review Board (DPU/ R&R[D]/971/[14]/16).

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Making inferior alveolar nerve block more comfortable via computer-controlled local anesthetic delivery: A prospective clinical study 원문보기

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Making inferior alveolar nerve block more comfortable via computer-controlled local anesthetic delivery: A prospective clinical study 원문보기

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