Summary Trial/Oral Surgery
Evidence-Based Dentistry (2007) 8, 5–6. doi:10.1038/sj.ebd.6400492
Intra-operative local anaesthesia to reduce postoperative pain or distress in children after exodontia under general anaesthesia
In paediatric patients does intra-operative local anaesthesia reduce postoperative pain?
Address for correspondence: Paul Coulthard, School of Dentistry, University of Manchester, Higher Cambridge Street, Manchester M15 6FH, UK. E-mail: paul.coulthard@man.ac.uk.
Avril Macpherson1
1Special Care and Sedation Department, NHS Lothian Salaried Primary Care Dental Service, Edinburgh, Scotland, UK
Coulthard P, Rolfe S, Mackie IC, Gazal G, Morton M, Jackson-Leech D. Intraoperative local anaesthesia for paediatric postoperative oral surgery pain — a randomized controlled trial. Int J Oral Maxillofac Surg 2006; 35:1114–1119
Abstract
Design
A randomised controlled trial (RCT).
Intervention
The appropriate drugs and dosage, namely 2 ml of 2% lidocaine with 1:200 000 epinephrine (adrenaline), or placebo of 2 ml of 0.9% sodium chloride, were administered by buccal infiltration injection adjacent to the teeth to be removed, after induction of general anaesthesia (GA).
Outcome measure
Pain scores were recorded pre-operatively and after treatment upon waking, after 30 min and after 24 h; distress scores were recorded pre-operatively, upon waking and after 30 min following treatment. Lip and cheek biting injuries were also recorded.
Results
One hundred and forty-two children were recruited to the study and randomly allocated to one of the two groups. Data were incomplete for three children. There were no statistically significant differences between the mean pain scores for the local anaesthetic and placebo group pre-operatively, on waking from the GA, at 30 min postoperatively or after 24 h. There were statistically significant increases in pain in both groups from pre-operative levels, with 13% of treatment and 12% of control patients recording severe pain and 13% of treatment and 10% of control patients recording very severe pain. These rates were similar at 30 min but reduced at 24 h following treatment. Lip or cheek biting injuries occurred in one control and three treatment patients.
Conclusions
Intra-operative local anaesthesia has been found to be effective for pain control following a range of other surgical procedures, but we did not find it to be effective in reducing postoperative pain or distress in children after oral surgery.
