Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: 15 Dec 2021

Effect of Intrapapillary Local Anesthetic on Postoperative Pain Following Dental Treatment Under General Anesthesia in Pediatric Patients

DDS, MS,
DDS, MS,
DDS, MS,
DMD, MS,
MD,
PhD, and
DDS, MS
Page Range: 206 – 213
DOI: 10.2344/anpr-68-02-06
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Objective:

This randomized, prospective, blinded study compared pain in children following dental treatment under general anesthesia (GA) using 1 of 2 established analgesia methods.

Methods:

Patients age 4 to 7 years were randomly assigned to a control group (intravenous [IV] analgesics) or experimental group (IV analgesics and intrapapillary local anesthetic infiltrations) between July 2017 and February 2018. During recovery from surgery, Faces, Legs, Activity, Cry, and Consolability (FLACC) scores were recorded upon regaining consciousness and reassessed every 15 minutes until discharge. Overall pain occurrence (FLACC ≥1) and moderate/severe pain occurrence (FLACC ≥4) were analyzed using mixed effects logistic regression (N = 88).

Results:

The experimental group had a 17% lower overall pain occurrence than the control group (16 vs 33%; p = .02). Moderate/severe pain occurrence between the groups was not significant (9 vs 22%; p = .23). The dental treatment subjects received (number of completed stainless steel crowns, extractions, and/or pulpotomies) did not significantly affect pain occurrence.

Conclusion:

Local anesthesia intrapapillary infiltrations around stainless steel crowns decrease overall pain occurrence but not moderate/severe pain occurrence following dental treatment under GA in pediatric patients.

Copyright: © 2021 by the American Dental Society of Anesthesiology
Figure 1.
Figure 1.

Wong-Baker FACES Pain Rating Scale.


Figure 2.
Figure 2.

Faces, Legs, Activity, Cry, and Consolability (FLACC) Scale.


Figure 3.
Figure 3.

Faces, Legs, Activity, Cry, and Consolability (FLACC) scores during postanesthesia care unit (PACU) stay.


Figure 4.
Figure 4.

Occurrence of overall and moderate/severe pain.


Contributor Notes

Address correspondence to Dr Kelly Lipp, Department of Pediatric Dentistry, Ohio State University, 380 Butterfly Garden's Drive, Columbus, OH 43215; kellymlipp@gmail.com.
Received: 07 Jan 2021
Accepted: 23 Mar 2021
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