Effectiveness of two-stage versus one-stage injection in reducing discomfort during inferior alveolar nerve block in children | ||||
| Egyptian Dental Journal | ||||
| Article 17, Volume 65, Issue 4 - October (Orthodontics, Pediatric & Preventive Dentistry), October 2019, Page 3233-3239 PDF (406.88 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/edj.2019.73999 | ||||
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| Authors | ||||
| Randa Youssef Abd Al Gawad1; Nada Mohamed Wassef2 | ||||
| 1Associate Prof. of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University | ||||
| 2Lecturer of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University | ||||
| Abstract | ||||
| Background: Inferior alveolar nerve block (IANB) anesthesia is a painful procedure & many attempts are made to render the injection painless, especially in children. Aim: To assess discomfort expressed during modified two-stage IANB injection versus one-stage injection in 8-10 years old children. Subjects & Methods: Sixty children were randomly & equally allocated to either intervention group (two-stage) or control group (one-stage). For all patients, topical anesthesia gel was applied. Intervention group: A short needle was used for the initial piercing & deposition of the local anesthesia (LA), the needle was inserted for 4mm & 0.4ml of the solution was deposited, then withdrawn. After 5 min, a long needle (gauge 27) was advanced till the point of LA drug deposition & bone touching & the rest of the LA solution was deposited. Control group: A long needle was inserted, dropping 0.4 ml of the solution incrementally till the point of LA drug deposition & bone touching & the rest of the LA solution was deposited. The overall patients’ levels of discomfort were assessed using Face Legs Activity Cry Consolability scale (FLACC) & Facial Image Scale (FIS). Results were tabulated & statistically analyzed. Results: For FLACC scale, the post-anesthetic values recorded a median=1 (range=0-3) in two-stages group, & a median=2 (range=0-4) in one-stage group; with statistically significant difference between them (p=0.00). For FIS, a median=2 (range=1-4) in the two-stage group & a median = 3 (range=1-5) in one-stage group; the difference between groups was statistically significant (p=0.017). Conclusion: The two-stage IANB injection technique is a simple & an effective method of reducing the overall discomfort in children. | ||||
| Keywords | ||||
| Discomfort; Inferior alveolar nerve block; local anesthesia; one-stage IANB; two-stage IANB | ||||
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