Effect of Intraligamentary Anaesthesia in Reducing Pain During Primary Molars Extractions Under General Anesthesia: A randomized Clinical Trial.

Abstract

Dentist anesthetists are always recommending the use of local anesthesia (LA) during tooth extractions to block any noxious stimulus and maintain the child vital signs with minimal interference. Objective: To evaluate the effect of intraligamentry anaesthesia (ILA) in reducing child pain and maintaining the vital signs during mandibular primary molars extraction under general anaesthesia (GA). Study design: A split-mouth controlled randomized clinical study was performed on 20 healthy children age ranging from 4-5 years indicated for complete oral rehabilitation under GA, with at least two bilateral mandibular primary molars indicated for extractions. A total of 40 primary molars were extracted, teeth were randomly assigned into two groups: Group A (extraction with ILA) and Group B (extraction without LA). Heart rate (HR) and mean arterial blood pressure (MABP) were used as parameters of pain, they were recorded before extraction (baseline data), and during the extraction procedure. The need of anesthetist intervention during extractions was also recorded. Results: There was no statistically significant difference between the baseline vital parameters (HR, MABP) and during extraction using ILA (p= 0.195, p=0.133 respectively). There was a statistically significant increase in the vital parameters (HR, MABP) during extractions without LA compared to both the baseline and during extraction using ILA (p= 0.000*). The need of anaesthetist intervention was statistically greater when extracting without LA than during extraction with ILA (p=0.00026).