A Comparison of Intraoral Injection Discomfort Produced: RESULTS

In: Anesthesia

23 Nov 2009

The pH of the plain lidocaine solution was 6.6; the epi-nephrine-containing solution’s pH was 4.4.

Twelve volunteers (6 men, 6 women) recorded at least one of their buccal injections at a minimum of 30 mm on the VAS, and 17 participants (10 men, 7 women) had palatal injection scores of at least 30 mm for one injection. The results are shown in the Figure and Tables 1 and 2.

Figure. Mean visual analogue scale

Figure. Mean visual analogue scale (VAS) scores in mm for each injection. Buccal epi indicates buccal infiltration with 2% lidocaine with 1:80,000 epinephrine; buccal plain, buccal infiltration with 2% lidocaine; 1st buccal, first buccal injection of the pair; 2nd buccal, second buccal injection of the pair; pal epi, palatal infiltration with 2% lidocaine with 1:80,000 epinephrine; pal plain, palatal infiltration with 2% lidocaine; 1st pal, first palatal injection of the pair; and 2nd pal, second palatal injection of the pair.

Buccal injection discomfort was less when the plain solution was used. The mean difference between solutions for buccal injections was 10 mm with a standard error of 4.3 (t = 2.3; P = .04); for palatal injections there was no significant difference between solutions, the mean difference was 2.7 mm with a standard error of 2.5 (t = 1.1; P= .29).
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Table 1.

Volunteer    Plain solution Epinephrine-containing solution
1 27 33t
2 27t 55
3 73 81t
4 21 43t
5 22f 55
6 30 27t
7 21t 30
8 42 55t
9 17t 31
10 35t 30
11 48t 27
12 24t 40
Mean 32.25 42.25
SD 15.75 16.44
* VAS, visual analogue scale, t = first injection of pair.

The difference between first and second buccal injections was not significant (t = 0.37; P = .72). However, the second palatal injection was more uncomfortable than the first (t = 2.17; P = .046).
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Table 2.

Volunteer    Plain solution Epinephrine-containing solution
1 70t 76
2 57t 60
00 25t 35
4 22t 37
5 49 34t
6 68 61t
7 66 65t
8 72 75t
9 38 46t
10 35 29t
11 34 31t
12 46 59t
13 63t 74
14 39t 50
15 47t 40
16 32t 51
17 56 42t
Mean 48.18 50.88
SD 16.14 15.86
* VAS, visual analogue scale, t = first injection of pair.

There were no differences in the pain scores between men and women. The mean ± SD total buccal pain scores for men and women were 66.5 ± 17.9 mm and 79.2 ± 37.3 mm, respectively (t = 1.9; P = .09). The mean ± SD total palatal scores for men and women were 103.5 ± 30.8 mm and 91.3 ± 28.6 mm, respectively (t = 0.84; P = .42).
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