The effectiveness of cryotherapy and cooled topical anesthesia compared with conventional topical anesthesia in alleviating intraoral injection pain: A systematic review and meta-analysis.

IF 2.3 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
Pooya Saeedi, Alireza Sarraf Shirazi, Mahsa Ghorbani
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引用次数: 0

Abstract

Background: Injection pain remains a significant concern in dental procedures, often leading to patient anxiety and reluctance to seek necessary care.

Aim: This study aimed to assess the effectiveness of cryotherapy in reducing injection pain compared with topical anesthesia during intraoral local anesthesia.

Design: MEDLINE, Web of Science, EMBASE, Scopus, and Cochrane's CENTRAL databases were searched up to November 2023. Inclusion criteria involved randomized clinical trials aligned with the PICO question. Study selection, data extraction, and risk of bias assessment using the ROB-2 tool were performed. The results were synthesized through a random-effects inverse variance meta-analysis. The primary outcomes assessed were the Visual Analogue Scale (VAS) and Sound Eye Motor (SEM). Subgroup analysis was conducted for children and adults.

Results: In the meta-analysis, 31 RCTs involving 2470 subjects were included. Twenty-seven studies demonstrated cryotherapy's significant superiority over topical anesthesia in reducing injection pain via VAS in adults (p = .01), children (p = .01), and combined age groups (p < .001). Additionally, cryotherapy significantly outperformed topical anesthesia in reducing pain via SEM in children (p = .04) and combined age groups (p = .03) across 13 studies, with no significant difference in adults (p = .51). Furthermore, cooled topical anesthesia also outperformed room temperature topical anesthesia (p < .001). The certainty of the results, however, is of very low quality.

Conclusions: Our results indicate that cryotherapy significantly reduces injection pain compared with topical anesthesia, especially in children and combined age groups, but is less effective in adults. Additionally, cooled topical anesthesia is more effective than room temperature topical anesthesia. Thus, cryotherapy is a and potentially superior alternative to topical anesthesia, particularly for children.

冷冻疗法和冷冻局部麻醉与传统局部麻醉相比在减轻口内注射疼痛方面的效果:系统回顾和荟萃分析。
背景:目的:本研究旨在评估在口腔局部麻醉过程中,与局部麻醉相比,冷冻疗法在减轻注射疼痛方面的有效性:设计:检索了截至 2023 年 11 月的 MEDLINE、Web of Science、EMBASE、Scopus 和 Cochrane's CENTRAL 数据库。纳入标准包括与 PICO 问题一致的随机临床试验。使用 ROB-2 工具进行了研究筛选、数据提取和偏倚风险评估。研究结果通过随机效应逆方差荟萃分析进行综合。评估的主要结果是视觉模拟量表(VAS)和声眼动量表(SEM)。对儿童和成人进行了分组分析:在荟萃分析中,共纳入了 31 项研究,涉及 2470 名受试者。27 项研究表明,在通过 VAS 减轻注射疼痛方面,冷冻疗法在成人(p = .01)、儿童(p = .01)和综合年龄组(p < .001)中明显优于局部麻醉。此外,在 13 项研究中,冷冻疗法在通过 SEM 减轻儿童(p = .04)和综合年龄组(p = .03)的疼痛方面明显优于局部麻醉,而在成人中则无明显差异(p = .51)。此外,低温局部麻醉的效果也优于室温局部麻醉(p < .001)。然而,这些结果的确定性很低:我们的研究结果表明,与局部麻醉相比,冷冻疗法能明显减轻注射疼痛,尤其是在儿童和混合年龄组中,但在成人中效果较差。此外,低温局部麻醉比室温局部麻醉更有效。因此,冷冻疗法是局部麻醉的一种潜在优越替代方法,尤其是对儿童而言。
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来源期刊
CiteScore
5.50
自引率
2.60%
发文量
82
审稿时长
6-12 weeks
期刊介绍: The International Journal of Paediatric Dentistry was formed in 1991 by the merger of the Journals of the International Association of Paediatric Dentistry and the British Society of Paediatric Dentistry and is published bi-monthly. It has true international scope and aims to promote the highest standard of education, practice and research in paediatric dentistry world-wide. International Journal of Paediatric Dentistry publishes papers on all aspects of paediatric dentistry including: growth and development, behaviour management, diagnosis, prevention, restorative treatment and issue relating to medically compromised children or those with disabilities. This peer-reviewed journal features scientific articles, reviews, case reports, clinical techniques, short communications and abstracts of current paediatric dental research. Analytical studies with a scientific novelty value are preferred to descriptive studies. Case reports illustrating unusual conditions and clinically relevant observations are acceptable but must be of sufficiently high quality to be considered for publication; particularly the illustrative material must be of the highest quality.
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