• Journal of Dental Anesthesia and Pain Medicine
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• v.24 no.2
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• pp.119-128
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• 2024

Background: In pediatric dentistry, fear and anxiety are common among children. Local anesthetics (LA) are widely used to control pain and reduce discomfort in children during dental treatment. Topical anesthetics play a vital role in reducing pain and the unpleasant sensation of a needle puncture in children. Peppermint oil has been extensively used for various diseases. However, its anesthetic properties remain unknown. Peppermint oil, used in mouthwashes, toothpastes, and other topical preparations has analgesic, anesthetic, and antiseptic properties. This study aimed to compare and evaluate pain perception following the topical application of peppermint oil versus lignocaine spray before an intraoral injection in children, aged 8-13 years. Method: Fifty-two children, aged between 8-13 years, who required local anesthesia for dental treatment were divided into two groups of 26 each by simple random sampling (Group 1: 0.2% peppermint oil and Group 2: lignocaine spray). In both groups, physiological measurements (e.g., heart rate) were recorded using pulse oximetry before, during, and after the procedure. Objective pain measurement (Sound Eye Motor (SEM) scale) during administration and subjective measuremeant (Wong-Baker Faces Pain Rating Scale (WBFPRS)) after LA administration were recorded. This was followed by the required treatment of the child. Physiological parameters were compared between the two groups using an independent t-test for intergroup assessment and a paired t-test and repeated-measures ANOVA for intragroup comparisons. The Mann-Whitney U test was used to analyze the pain scores. Results: Intragroup mean heart rates, before, during, and after treatment were statistically significantly different (P < 0.05). However, the intergroup mean pulse rates did not differ significantly between the two groups. The mean WBFPS score in the lignocaine spray group was 4.133 ± 2.06 was statistically different from that of the peppermint oil group (0.933 ± 1.03; P < 0.001^*). The mean SEM score was significantly lower in the peppermint oil group than that in the lignocaine spray group (P = 0.006). No negative effects were observed in this study. Conclusion: 0.2% peppermint oil was effective in reducing pain perception.

• The Journal of Korean Physical Therapy
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• v.10 no.1
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• pp.1-6
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• 1998

The purpose of this study was to determine the of effective concentration of procaine iontophoresis for durarion of cutaneous local anesthesia. Forty-five healthy students with an age range of 19 to 34 years$(21\pm2.7)$, were participated in this study. The subjects were randomly assigned into 5 groups. Bach 9 subjects received iontophoresis on the flexor surface of dominant forearm with soft cotton pad $(3.5\times3.5cm)$ soaked in 2ml of $2\%$ (pH 5.28), $4\%$ (pH 5.12), $8\%$ (pH 4,98), $16\%$ (pH 4.72), $32\%$ (pH 4.52) procaine hydrochloride solution at 4mA for 10 minutes (total current 40mA min) using anodal direct current. The study was performed in a randomized, double-blind design, After procaine iontophoresis, the duration of anesthesia were evaluated at five minute intervals on five random locations in the iontophoretically area using a 21-gauge sterile hypodermic needle pressed with 1mm invagination unitl sharp pin-pricking pain sensation returned. The data were analyzed with one-way ANOVA to determine significant differences between groups. Duncan post hoc was performed at level .01. The relationship between anesthetic duration and procaine concentration was assessed with Pearson Product-Moment Correlation Coefficients. ANOVA tests showed significant differences in the anesthetic duration between the concentration of procaine solution (p<.001). Procaine iontophoresis with $4\%$ concentration produced cutaneous Socal anesthesia of significantly longer duration(15.56 min) than iontophoresis with $2\%,\;8\%,\;16\%$, and $32\%$ of procaine GCl(p<.01). Whereas the anesthetic duration had no correlation with concentration of procaine solution (r=-0.41, NS). These results support the $4\%$ procaine solution was an effective concentration of iontophoresis for induced cutaneous local anesthesia.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.1
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• pp.69-75
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• 2002

A number of techniques may be employed to reduce the discomfort of syringe or needle for dental care. The use of topical anesthesia is one such method. Topical anesthetics are applied to alleviate pain during many clinical procedures, such as injection of local infiltration anesthetics, primary tooth extraction, X-ray taking of sensitive patients, reducing gag reflex prior to impression taking. In children, placement of a rubber dam clamp, however, may cause significant discomfort for purpose of pit and fissure sealant and preventive resin restoration(PRR). A topical anesthetic would be beneficial to aid in rubber dam placement for this purpose. It has been suggested that all intra-oral topical anesthetics are equally effective on reflected mucosa, however EMLA(an acronym for eutectic mixture of local anesthetics), which was developed in the 1980s and produces surface anesthesia of skin, has been shown to be more effective than conventional topical anesthetics when used on attached gingivae. This report is topical anesthesized 4 case by EMLA cream, who showed better effect in reducing the pain of infiltration anesthesia, extraction of deciduous teeth, rubber dam clamp placement and reducing the pain of preformed crown adaptation.

• Korean Journal of Veterinary Research
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• v.39 no.1
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• pp.240-246
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• 1999

forty-five claw lamed cows with pododermatitis circumscripta, hyperplasia interdigitalis, and dermatitis verrucosa were treated surgically through resection of necrotic tissues, currettage, antibiotics application, and compressive bandage, under retrograde intravenous regional anesthesia of claw. At 7 days postoperation were showed lameness score 0, absense of swelling of extremitis, without fistulation and purulent exudate in wound. Mean duration time of action of local anesthetic drug was 75 minutes and mean operation time for treatment of pododermatitis circumscripta, hyperplasia interdigitalis, and dermatitis verrucosa was 35 minutes, 20 minutes, and 21 minutes, respectively.

• Journal of The Korean Dental Society of Anesthesiology
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• v.6 no.2 s.11
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• pp.98-102
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• 2006

The purpose of this study was to evaluate the difference on pain intensity and discomfort between pressure-controlled injection system and conventional syringe injection technique from the patients undergoing oral and maxillofacial surgery. In a prospective, randomized, case-controlled study, 60 patients were divided into two groups (n=30 in each). In experimental group, pressure-controlled injection system was applied. In control group, conventional syringe injection system was applied. Pain rating score (PRS) and visual analogue scale (VAS) were assessed. The average of VAS in experimental group ($16.67{\pm}15.07$) was smaller than that of control group ($25.63{\pm}22.21$), though there were no significant differences (P=0.072). In PRS, fifteen patients (50.0%) of experimental group answered that they experienced mild pain. However sixteen patients (53.3%) of control group answered that they experienced intermediate pain. From the results, pressure-controlled injection system may be an effective method to reduce pain during the dental local anesthetic procedure.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.3
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• pp.135-141
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• 2019

Background: The fear of needle insertion and pain during anesthesia is a source of patient dissatisfaction in dentistry. Inferior alveolar nerve block (IANB) remains the most common type of block and is in itself painful. Computer-controlled local anesthetic delivery (CCLAD) has been proven to reduce the pain associated with injection of anesthetics in various blocks. However, the efficacy of CCLAD for IANB in adults remains unknown. Methods: Sixty-four adult patients requiring bilateral IANB were selected and divided into two groups: group A (50 patients receiving IANB via CCLAD) and group B (50 patients receiving IANB using a conventional cartridge syringe). Pain perception and patient comfort were assessed using the visual analog scale and the 5-point semantic scale, respectively. Results: The pain perception was compared between the two groups using the Mann-Whitney U-test, and the P value was 0.003. The patient comfort was also compared using the same test, and the P value was 0.484. Conclusion: A significant difference was observed in the pain perception of the patients during CCLAD. The patient comfort was grossly equal for both techniques.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.3
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• pp.175-180
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• 2019

Although allergic reactions are not rare complications in drug use, anaphylaxis or anaphylactoid reactions to some widely used drugs can embarrass clinicians because anaphylaxis is not easily diagnosed at the time of the event and treatment is unfamiliar to many. Lidocaine is a very popular drug in dental procedures and anaphylactoid reaction to it has been rarely reported. Clinicians who use lidocaine daily should, however, be aware of the possibility of anaphylaxis after its use. Once it occurs, anaphylaxis can be fatal, but if it is quickly diagnosed or suspected, treatment is simpler than most clinicians believe. An 86-year-old woman experienced an anaphylactic reaction 30 min after local infiltration of lidocaine for retraction of retained teeth. The dentist called an anesthesiologist for assistance. Fortunately, an anaphylactic reaction was quickly suspected and after subsequent rapid treatment with the administration of fluid and drug therapy, the patient recovered completely.

• The Korean Society of Law and Medicine
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• v.18 no.1
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• pp.61-99
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• 2017

Medical practices such as surgery often need to accompany anesthesia, which frequently causes medical accidents. In order to determine whether a medical accident related to anesthesia was caused by a doctor's fault, it is necessary to understand what is the duty of care required for the medical staff such as a doctor through all stages of anesthesia. This paper analyzed Supreme Court decisions since 1990s and recent lower courts' decisions in order to understand standard of care with respect to anesthesia. While numerous medical accidents were related to inhalation anesthesia in the past, it turned out that recent medical accidents were often related to the use of intravenous or local anesthetics. In particular, legal disputes with respect to medical accidents related to propofol have considerably increased since 2007. However, because Supreme Court decisions as to anesthesia accidents are mostly related to inhalation anesthesia, they seem to be insufficient to set standard of care as to other types of anesthesia accidents. In light of the fact that medical accidents related to the use of propofol have been increasing, it is critical to establish and maintain clinical guidelines on the use of each anesthetic in the medical field. However, The Courts can present the standard of care suitable for medical reality to serve as a compass for medical practices.

• Journal of Yeungnam Medical Science
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• v.35 no.1
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• pp.45-53
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• 2018

Background: Carotid endarterectomy (CEA) has been performed under regional and general anesthesia (GA). The general anesthesia versus local anesthesia for carotid surgery study compared the two techniques and concluded that there was no difference in perioperative outcomes. However, since this trial, new sedative agents have been introduced and devices that improve the delivery of regional anesthesia (RA) have been developed. The primary purpose of this pilot study was to compare intraoperative hemodynamic stability and postoperative outcomes between GA and ultrasound-guided superficial cervical plexus block (UGSCPB) under dexmedetomidine sedation for CEA. Methods: Medical records from 43 adult patients who underwent CEA were retrospectively reviewed, including 16 in the GA group and 27 in the RA group. GA was induced with propofol and maintained with sevoflurane. The UGSCPB was performed with ropivacaine under dexmedetomidine sedation. We compared the intraoperative requirement for vasoactive drugs, postoperative complications, pain scores using the numerical rating scale, and the duration of hospital stay. Results: There was no difference between groups in the use of intraoperative antihypertensive drugs. However, intraoperative inotropic and vasopressor agents were more frequently required in the GA group (p<0.0001). In the GA group, pain scores were significantly higher during the first 24 h after surgery (p<0.0001 between 0-6 h, p<0.004 between 6-12 h, and p<0.001 between 12-24 h). The duration of hospital stay was significantly more in the GA group ($13.3{\pm}4.6days$ in the GA group vs. $8.5{\pm}2.4days$ in the RA group, p<0.001). Conclusion: In this pilot study, intraoperative hemodynamic stability and postoperative outcomes were better in the RA compared to the GA group.

• Journal of Oral Medicine and Pain
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• v.13 no.1
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• pp.85-93
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• 1988

The author studied maximum clenching EMG activities of temporalis anterior and masseter muscle during canine guidance and centric occlusion. It was performed before and after anesthesia of maxillary and mandibular canines. The 22 normal subjects (15 males and 7 females) who had healthy maxillary and mandibular canines were selected. Their occlusal contact scheme was canine guidance during movement and they did not have temporomandibular disorder. The results were as follows : 1. The maximum clenching EMG activities of temporalis anterior and masseter muscle during guidance were less than those during centric occlusion. 2. After left maxillary and mandibular canines were anesthetized with 2% lidocanine with 1:100,000 epinephrine, the maximum clenching EMG acivities of temporalis anterior and masseter muscle during left canine guidance were greater than those before anesthesia of left maxillary and mandibular canines(p<0.01) 3. The maximum clenching EMG activities of temporalis anterior and masseter muscle during right guidance were not significantly different between before and after anesthesia of left maxillary and mandibular canines(p>0.05).