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Clinical Oral Investigations

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03.09.2021 | Original Article

Effect of precooling injection site and cold anesthetic administration on injection pain, onset, and anesthetic efficacy in maxillary molars with symptomatic irreversible pulpitis: a randomized controlled trial

verfasst von: Ishwarya Gurucharan, Mahalaxmi Sekar, Saravanakarthikeyan Balasubramanian, Srinivasan Narasimhan

Erschienen in: Clinical Oral Investigations | Ausgabe 2/2022

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Abstract

Objective

This randomized controlled clinical trial assessed the analgesic and anesthetic effects of precooling the injection site and administration of refrigerated 2% lignocaine HCl with 1:100,000 epinephrine (LE) in maxillary molars with symptomatic irreversible pulpitis (SIP).

Materials and methods

Sixty patients diagnosed with SIP (preoperative pain score ≥ 85 mm) in maxillary first molars were randomly allocated to two groups. In group I (control), topical gel was applied for a minute followed by conventional LE infiltration, whereas in group II (experimental), topical ice application for 15 s and refrigerated (4–6 °C) LE administration was done prior to endodontic treatment. The primary outcome measure was anesthetic efficacy that was defined as none to weak pain (≤ 36 mm) as measured on Heft Parker visual analog scale (HP-VAS) following access cavity preparation. Pain on injection and onset constituted the secondary outcome measures. The pain on injection was measured using HP-VAS, whereas the onset of anesthesia was assessed using an electric pulp tester (EPT) which was applied on the experimental tooth every minute until no response was elicited. Mann–Whitney U test was performed to analyze the data (p < 0.01).

Results

Experimental group reported a success rate of 86.6% when compared to control group (26.6%) and a statistically significant reduction on injection pain (20.0 mm vs 54.5 mm) (p < 0.01). The onset of anesthesia for experimental group was 2.4 min which was also significantly lower than control group (4.5 min) (p < 0.01).

Conclusions

Cryotherapy can serve as an effective alternative to conventional anesthesia for achieving success, reduced pain, and faster onset during endodontic treatment of maxillary molars with SIP.

Clinical relevance

Precooling the injection site and cold LE administration can result in effective pulpal anesthesia during endodontic management of maxillary molars in SIP patients.

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Titel: Effect of precooling injection site and cold anesthetic administration on injection pain, onset, and anesthetic efficacy in maxillary molars with symptomatic irreversible pulpitis: a randomized controlled trial
verfasst von: Ishwarya Gurucharan
Mahalaxmi Sekar
Saravanakarthikeyan Balasubramanian
Srinivasan Narasimhan
Publikationsdatum: 03.09.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Oral Investigations / Ausgabe 2/2022
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-021-04160-8

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Effect of precooling injection site and cold anesthetic administration on injection pain, onset, and anesthetic efficacy in maxillary molars with symptomatic irreversible pulpitis: a randomized controlled trial