title: Reduction of pain from needle stick in the oral mucosa by topical anesthetics: a comparative study between lidocaine/prilocaine and benzocaine.
abstract: OBJECTIVE
  The aim of the study was to compare the analgesic effect of a topical benzocaine gel with that of a topical gel mixture of lidocaine/prilocaine (L/P).
  
  
  METHODS
  Forty individuals took part in the study. Topical anesthetics were applied bilaterally in the maxillary vestibule lateral to the canine. On one side, a mixture of 2.5% lidocaine/2.5% prilocaine (EMLA) was applied. On the opposite side, 20% benzocaine (Topex) was applied as control. The patients had no knowledge as to which side each gel was applied. A 27-gauge needle was inserted through the mucosa to bone contact every minute during a seven-minute period in each area of application. The subjects recorded which side was the least painful, and also registered the grade of pain on a 100 mm VAS scale. Comparisons were made estimating the group difference using the Wilcoxon rank sum test.
  
  
  RESULTS
  After one minute, 87.5% of the subjects reported the L/P side being the least painful. After two to four minutes, 97.5-100% reported the L/P side least painful. After five to seven minutes, 90-95% reported the L/P side least painful. The VAS grading of the pain showed that L/P was significantly (p < 0.05) better in eliminating or reducing the pain.
  
  
  CONCLUSIONS
  Topical anesthetics based on a combination of lidocaine 2.5% + prilocaine 2.5% are significantly more effective than 20% benzocaine in reducing pain from needle stick in the maxillary vestibular mucosa.
authors.affiliation: Faculty of Dentistry, Health Sciences Centre, Kuwait University, Kuwait. dentist@qualitynet.net
authors.forename: Manal
authors.initials: M
authors.lastname: Abu Al-Melh
authors.forename: Lars
authors.initials: L
authors.lastname: Andersson
authors.forename: Ebraheem
authors.initials: E
authors.lastname: Behbehani
mesh_terms: D000328:Adult; D019162:Anesthetics, Combined / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001566:Benzocaine / Q000008:administration & dosage*; D003481:Cuspid; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D000077442:Lidocaine, Prilocaine Drug Combination; D009061:Mouth Mucosa / Q000187:drug effects*; D009339:Needles / Q000009:adverse effects*; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011318:Prilocaine / Q000008:administration & dosage*; D013997:Time Factors
chemical_list: D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D008012:Lidocaine; D001566:Benzocaine