The Effect of Pre-cooling the Injection Site on Pediatric Pain Perception during the Administration of Local Anesthesia

Abstract

Aim:The aim of the study was to evaluate the effect of cooling the soft tissue of injection sites on the pain perceptions of pediatric patients during the administration of local anesthesia for routine dental procedures. Methods and Materials:A total of 160 children aged 5-6 years were included in the present study. On a random basis, the subjects were allocated to the without ice pretreatment (WIP) group (topical anesthesia + counterstimulation + distraction) or the ice pretreatment (IP) group (cooling + topical anesthesia + counterstimulation + distraction). During the administration of an inferior alveolar nerve block, the children's behavior was assessed using the sound, eye, and motor (SEM) scale. The statistical analysis of data was performed based on the analysis of variance (ANOVA).Results: There were no significant differences within the groups between the values of the sound, eye, and motor components for either the WIP or the IP groups (P>0.05). All three components of the SEM in the IP group were consistently lower than the WIP group (P<0.05). Moreover, the SEM value for the WIP group surpassed the IP group (P<0.05). Conclusions:Cooling the site of infiltration block prior to the injection of local anesthesia significantly reduced the pain perceived during injection of local anesthetic agent in pediatric patients. Abstract © Seer Publishing

Minimizing the Pain of Local Anesthesia Injection

“…50,58 The use of vibration in dental procedures has shown to decrease the pain of needle insertion. 55,59 The stimuli increase the "sensory noise" perceived by the brain in the area of the needlestick. This is the mechanism that explains why rubbing a stubbed toe seems to dissipate some of the pain.…”

“…8 Applying ice before needle insertion has been found to reduce pain in many trials. [54][55][56] Ice is frequently used in dental practice to dull the pain of needle insertion into mucosa. 55,57 In the mucosa of the palate, ice provided more effective pain reduction, decreased application time requirement, greater ease of application, and avoidance of displeasing taste when compared with eutectic mixture of local anesthetic creams.…”

“…[54][55][56] Ice is frequently used in dental practice to dull the pain of needle insertion into mucosa. 55,57 In the mucosa of the palate, ice provided more effective pain reduction, decreased application time requirement, greater ease of application, and avoidance of displeasing taste when compared with eutectic mixture of local anesthetic creams. 57 The results of a study comparing the efficacy of eutectic mixture of local anesthetic topical anesthesia and the application of ice before cutaneous needle insertion showed that the eutectic mixture of local anesthetic provided better pain control but was hindered by the slow onset, whereas ice was inexpensive, fast-acting, and readily available, and still produced statistically significant pain reduction.…”

The Effıcacy of External Cooling and Vibration on Decreasing the Pain of Local Anesthesia Injections During Dental Treatment in Children: A Randomized Controlled Study

“…Similarly, many researchers have found that cold application on the injection site before local anesthesia injections significantly reduces the pain perceived by children at the time of injection. 21,22 In their study comparing the impact of cold application to that of local anesthetic gel application before injection of anesthetics on the pain at the time of injection, Kosaraju and Vandewalle 17 determined that pain scores of the cold application group were lower than those of the gel group, and refrigerant application significantly reduced the pain associated with anesthesia injections.…”

“…15 It can reduce the pain perceived by children and the distress associated with injections, and facilitates the management of children's pain related to dental procedures. 15,22…”