title: The effects of a 2-stage injection technique on inferior alveolar nerve block injection pain.
abstract: The purpose of this prospective, randomized, single-blinded, crossover study was to compare the pain of a traditional 1-stage inferior alveolar nerve (IAN) block injection to a 2-stage IAN block technique. Using a crossover design, 51 subjects randomly received, in a single-blinded manner, either the traditional IAN block or the 2-stage IAN block in 2 appointments spaced at least 1 week apart. For the 2-stage injection, the needle was inserted submucosally and 0.4 mL of 2% lidocaine with epinephrine was slowly given over 1 minute. After 5 minutes, the needle was reinserted and advanced to the target site (needle placement), and 1.8 mL of 2% lidocaine with epinephrine was deposited. For the traditional IAN block, following needle penetration, the needle was advanced while depositing 0.4 mL of 2% lidocaine with epinephrine (needle placement) and then 1.8 mL of 2% lidocaine with epinephrine was deposited at the target site. A Heft-Parker visual analogue scale was used to measure the pain of needle insertion, needle placement, and anesthetic solution deposition. There were no significant differences, as analyzed by Wilcoxon matched-pairs signed-ranks test, between needle insertion and solution deposition for the 2 techniques in men or women. However, there was significantly less pain with the 2-stage injection for needle placement in women. In conclusion, the 2-stage injection significantly reduced the pain of needle placement for women when compared to the traditional IAN technique.
authors.affiliation: Section of Endodontics, The Ohio State University, Columbus 43218, USA.
authors.forename: John
authors.initials: J
authors.lastname: Nusstein
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Steinkruger
authors.forename: Al
authors.initials: A
authors.lastname: Reader
authors.forename: Mike
authors.initials: M
authors.lastname: Beck
authors.forename: Joel
authors.initials: J
authors.lastname: Weaver
mesh_terms: D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007267:Injections / Q000379:methods; D008297:Male; D008340:Mandibular Nerve; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010146:Pain / Q000523:psychology*; D012737:Sex Factors