J Dent Anesth Pain Med.  2018 Dec;18(6):367-373. 10.17245/jdapm.2018.18.6.367.

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 K
• Lamba AK
• Faraz F
• Tandon S
• Makker K

• KMID: 2430214
• DOI: http://doi.org/10.17245/jdapm.2018.18.6.367

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.

Keyword

Computer-controlled Local Anesthetic Delivery System; Local Anesthesia; Pain; Pain Perception; Visual Analogue Scale

MeSH Terms

Anesthesia*
Anesthesia, Local*
Anxiety*
Appointments and Schedules
Dental Care
Humans
Mandibular Nerve*
Needles
Nerve Block
Pain Perception
Syringes

Figure

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  Fig. 1 The visual analogue scale (VAS) used for evaluating the perceived pain among patients.

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  Fig. 2 The computer controlled local anesthetic delivery system.

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  Fig. 3 Comparison of mean anxiety scores between the computer controlled local anesthesia delivery system and conventional syringe.

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  Fig. 4 Pen-grasp used in the computer controlled local anesthesia delivery system.

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