Use of Pre-Injection Diffusion of Local Anaesthetic as a Means of Reducing Needle Penetration Discomfort.
OBJECTIVE
To determine if pre-injection diffusion of local anaesthetic solution influences the discomfort of needle penetration in the palate.


METHODS
A placebo-controlled, randomised, double-blind split-mouth investigation was conducted. 25 healthy adult volunteers were recruited and each received two needle penetrations in a random order during one visit. The penetration sites were 1 cm from the gingival margin of the first maxillary premolars on each side of the mouth. 30 gauge-13 mm needles which were attached to syringes that contained either 2% lidocaine with 0.125mg/ml epinephrine or physiological saline were used. For each penetration an operator encouraged a drop of solution to appear at the end of the needle and placed this drop with the bevel of the needle flat on the palate for 20 seconds. The discomfort was noted on a 100 mm visual analogue scale with end points marked "No pain" and "Unbearable pain".


RESULTS
There was no significant difference in penetration discomfort between solutions, (mean VAS = 26.80±19.36mm for lidocaine and 26.20±18.39mm for saline) however the 2nd penetration was significantly more uncomfortable than the first (mean VAS = 31.00±19.84 mm and 22.00±16.65 mm respectively).


CONCLUSIONS
Pre-injection diffusion of local anaesthetic solution did not influence the discomfort of needle penetration in the palate.
Dept.of Paediatric Dentistry, Dental School, Yeditepe University, Istanbul, Turkey; Private practice, Istanbul, Turkey.
Ozgur Onder
OO
Kuscu
Dept.of Paediatric Dentistry, Dental School, Yeditepe University, Istanbul, Turkey.
Nuket
N
Sandalli
Dept.of Paediatric Dentistry, Dental School, Yeditepe University, Istanbul, Turkey; Private practice, Istanbul, Turkey.
Esber
E
Caglar
School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK.
John G
JG
Meechan
diffusion; local anaesthesia; pain; pre-injection
Eur J Dent Educ. 2013 Aug;17(3):185-9
23815696
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Jun;101(6):e106-9
16731373
Anesth Prog. 2009 Summer;56(2):36-41
19642717
Pediatr Dent. 1999 Nov-Dec;21(7):421-4
10633514
Quintessence Int. 1994 Oct;25(10):713-6
9161249
Int J Paediatr Dent. 2002 Mar;12(2):80-9
11966886
J Am Dent Assoc. 1979 Nov;99(5):822-4
290678
Pediatr Dent. 2000 Nov-Dec;22(6):458-62
11132503
Int J Oral Surg. 1983 Dec;12(6):444-5
6425235
Anaesthesia. 1976 Nov;31(9):1191-8
1015603
Pediatr Dent. 2002 Jul-Aug;24(4):333-6
12212876
Pediatr Dent. 2001 Jan-Feb;23 (1):11-4
11242723
Quintessence Int. 2005 Jul-Aug;36(7-8):559-64
15997937
Int J Paediatr Dent. 2008 Mar;18(2):139-45
18237297
Compendium. 1991 Apr;12(4):262, 264-8
1893390
J Dent Child (Chic). 2006 May-Aug;73(2):116-21
16948374
Eur J Clin Pharmacol. 1982;23(5):441-4
7151849
Bull Tokyo Dent Coll. 2005 Aug;46(3):51-8
16598181
Gen Dent. 1981 Sep-Oct;29(5):417-8
6955239
Anesth Prog. 1987 Nov-Dec;34(6):215-9
3481519
Quintessence Int. 1994 Sep;25(9):641-6
7568718
Gen Dent. 1989 Nov-Dec;37(6):496-9
2639844
Br Dent J. 1968 Apr 2;124(7):303-9
5238619
Psychol Med. 1988 Nov;18(4):1007-19
3078045
Int J Oral Surg. 1975 Sep;4(4):151-6
809375
Anesth Prog. 2005 Winter;52(4):122-7
16596910
Pediatr Dent. 2002 Jul-Aug;24(4):315-20
12212873
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 Jul;90(1):88-94
10884642
J Clin Dent. 2005;16(2):53-6
16170977
Anesth Prog. 2005 Fall;52(3):91-4
16252738
J Am Dent Assoc. 1985 Oct;111(4):578-83
3863856