comparison of pain on injection and onset of anaesthesia of 2% buffered lidocaine with adrenaline and 2% non-buffered lidocaine with adrenaline in inferior alveolar nerve block for primary molars- a randomized double blind study

Not yet recruiting

Conditions: primary molars indicated for atleast two clinical sessions of dental procedures requiring inferior alveolar nerve block

Registration Number: CTRI/2020/02/023525

Lead Sponsor: Dr Shrawani Mankar

Brief Summary: Reduction in pain is one of the most important aspects of behaviour management in children undergoing dental treatment. Local anaesthesia administration is a prerequisite for pain reduction while performing various restorative, endodontic and minor surgical procedures in children. Inferior alveolar nerve block (IAN) is the most routinely used injection technique for achieving local anaesthesia for endodontic treatment of mandibular teeth. Pain caused during local anaesthesia administration has been attributed to many factors, including the speed of injection, site of injection, and pH of the anaesthetic solution.

Lidocaine is the most frequently used local anaesthetic (LA). It contains a vasoconstrictor and an antioxidant to prevent early oxidation of vasoconstrictor and increase the shelf life. This leads to low ph ranging from 2.9 and 4.4 which may produce a burning sensation on the injection site, a slower onset of anaesthesia and a decrease in its clinical efficacy. It has been suggested that alkalizing this acidic solution can reduce pain caused during administration of local anaesthesia. This also hastens the onset of anaesthesia by increasing the concentration of uncharged basic form and facilitating the penetration of lidocaine into the nerve cell.

The addition of sodium bicarbonate to LA also result in the production of carbon dioxide and water. Carbon dioxide potentiates local anaesthesia by 3 mechanisms. Firstly by having direct depressant effect on the axon. Secondly by concentrating LA inside the nerve trunk and lastly by converting LA to the active cation through its effect on pH at the site of action inside the nerve.

Studies have been conducted to assess the use of buffered lidocaine for infiltration and block anaesthesia during dental procedures in adults, but literature on the use of buffered lidocaine solution in children is sparse.

The **purpose of study** is tocompare pain on injection and onset of anaesthesia of 2 % buffered lidocaine(with 1 :2,00,000 adrenaline) and 2 % nonbuffered lidocaine (with 1:2,00,000 adrenaline) in inferior alveolar nerve block for primary molars: a randomized double blind study. This study was planned with hypothesis that there is a significant difference in pain on injection and onset of anaesthesia of 2% buffered lidocaine (with 1:2,00,000 adrenaline) and 2% nonbuffered lidocaine (with 1:2,00,000 adrenaline) in inferior alveolar nerve block for primary molars

Detailed Description: Not available

Recruitment & Eligibility

Status: Not Yet Recruiting

Sex: All

Target Recruitment: 60

Inclusion Criteria

healthy children indicated for atleast two similar clinical sessions of dental procedures requiring inferior alveolar nerve block and exhibiting Frankls behaviour rating score 3 or 4.

Exclusion Criteria

children with known history of allergy to any local anesthetic agent, active infection at the site if injection, history of dental treatment in last 6 months.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
pain on injection and onset of anesthesia	after administration of local anesthesia

Secondary Outcome Measures

Name	Time	Method
not applicable	not applicable

Trial Locations

Locations (1): V.S.P.M. Dental college and Research Centre, Nagpur
🇮🇳
Nagpur, MAHARASHTRA, India
V.S.P.M. Dental college and Research Centre, Nagpur
🇮🇳Nagpur, MAHARASHTRA, India
Dr Shrawani Mankar
Principal investigator
9970032254
drshrawani5@gmail.com