Application of analgosedation in adults with reduced pain threshold in dentistry

V.A. Paykush, N.M. Dydyk


Background. The purpose was to increase the efficiency of dental treatment in patients, who were excessively agitated and showed panic and fear before dental treatment, by combining the methods of analgosedation and local anesthesia. Materials and methods. Clinical features of the offered method are described according to the medical records of 42 patients, who all showed excessive worry about the upcoming manipulations due to previous insufficient analgesia during dental treatment. A combination of algosedation based on propophol and fentanyl, together with local anesthesia, was used for dental treatment of vital teeth in the above mentioned patients. Patients themselves evaluated efficiency of anesthesia using Visual Analogue Scale and visual and auditory recollections. Results. The clinical approach elaborated using the combined method of analgosedation and local anesthesia allowed the whole scope of a very effective treatment of all study group patients to be done in one visit. Time from the awakening from the sedation to the moment when patient was able to leave the clinic was 50 ± 30 minutes. Pain level in this group of patients according to Visual Analogue Scale was from 0 to 1. In first 24 hours after treatment, pain level was from 1 to 2, and on the third day after treatment, it was from 0 to 1. Conclusions. The combination of analgosedation based on propophol and fentanyl together with local anesthesia helps to provide painless dental treatment when local anesthesia is insufficient and when dental phobia (panic or fear) is present.


analgosedation; local anesthesia; dental anxiety; pain perception


Allegretti C.E., Sampaio R.M., Horliana A.C., Armonia P.L., Rocha R.G., Tortamano I.P. Anesthetic Efficacy in Irreversible Pulpitis: A Randomized Clinical Trial // Braz. Dent. J. 2016 Jul-Aug. — 27(4). — Р. 381-6.

Nusstein J.M., Reader A., Drum M. Local anesthesia strategies for the patientwith a «hot» tooth // Dent. Clin. North Am. — 2010 Apr. — 54(2). — Р. 237-47.

Astramskaitė I., Poškevičius L., Juodžbalys G. Factors determining toothextraction anxiety and fear in adult dental patients: a systematic review // Int. J. Oral. Maxillofac. Surg. — 2016 Dec. — 45(12). — Р. 1630-1643.

Fardal Ø., McCulloch C.A. Impact of anxiety on pain perception associated withperiodontal and implant surgery in a private practice // J. Periodontol. — 2012 Sep. — 83(9). — Р. 1079-85.

Armfield J.M., Heaton L.J. Management of fear and an­xiety in the dental clinic: a review // Aust. Dent. J. — 2013 Dec. — 58(4). — Р. 390-407; quiz 531.

Lin C.S., Wu S.Y., Yi C.A. Association between Anxiety and Pain in Dental Treatment: A Systematic Review and Meta-analysis // J. Dent. Res. — 2017 Feb. — 96(2). — Р. 153-162.

van Wijk A.J., Hoogstraten J. Anxiety and pain during dental injections // J. Dent. — 2009 Sep. — 37(9). — Р. 700-4.

Southerland J.H., Brown L.R. Conscious Intravenous Sedation in Dentistry: A Review of Current Therapy // Dent. Clin. North Am. — 2016 Apr. — 60(2). — Р. 309-46.,,



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