Evaluation of ice therapy as a pretreatment on reduction of injection pain and bleeding during periodontal surgery of maxilla after administration of prilocaine as a local anesthesia

Abstract

The effect of pretreatment with ice on reduction of bleeding can cause improvement of visibility, access and infection control during periodontal surgery. On the other hand, pain reduction leads to better patient control during the surgery. Therefore it seems that its clinical application would be more accepted. We evaluated the effect of cooling the soft tissue region of maxillary periodontal surgery with ice on injection pain and bleeding during surgery after administration of prilocaine without vasoconstrictor as a local anesthesia. Methods and materials: 80 patients who met the inclusion / exclusion criteria were randomized into 2 groups of case and control group. The patients in case group received pretreatment with ice for 2 minutes by the use of ice tubes in the soft tissue of injection and surgery site before injection of local anesthesia. However, there was no pretreatment with ice in the control group. After the injection a visual analogue scale, reported by the patient, was used to rate pain.The volume of blood loss during each surgery was measured by subtracting the amount of water used for irrigation (ml/min) from the total volume of fluid collected in the portable aspirator at the end of the surgery. All of the surgeries were done by the same surgeon and turbine. SPSS.17 used for analysis of data. Chi-square(X2) and T-test were used for comparison of average values of pain rates and amount of bleeding in control and case groups, respectively. P<0.05 was considered significant. Results: The results of volume of bleeding loss showed not a significant difference (P=0.879) between control (237.20 ml) and case (241.65 ml) groups. There was statistically significant (P=0.001) reduction in pain rates of local anesthesia injection when pretreatment with ice was done. Conclusions: Pretreatment with ice has no effect on bleeding amount during surgery after administration of prilocaine without vasoconstrictor. Also our study showed that pretreatment with ice is effective in pain reduction during injection.