A Comparison of Intraoral Injection Discomfort Produced: RESULTS

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 (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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