Reducing children's injection pain: Lidocaine patches versus topical benzocaine gel

Purpose: The purpose of this study was to compare the effectiveness of lidocaine patches and topical anesthetic gel in reducing injection pain in children. Methods: Thirty-two children received bilateral greater palatine injections of 0.2cc of 2% lidocaine with 1:100,000 epmephrine at the same visit. Injections followed a 15 minute application of DentiPatch™ (20% lidocaine) or a 1 minute application of topical anesthetic gel (Topex, 20% benzocaine). Each child completed a Faces Pain Scale and Visual Analog Scale after each injection and was asked which injection hurt more. Injections were videotaped and two independent evaluators, using the Sounds, Eyes, and Motor Scale, rated observed pain-related behavior. Inter-rater reliability was established at 96%. Results: A significant difference was shown in observed pain-sounds favoring use of the DentiPatch (P<.003, Wilcoxon Sign Rank Test). Using Wilcoxon Sign Rank Test and paired t-tests, no significant differences were shown in either reported pain or observed pain-motor. Conclusions: A statistically significant decrease in observed verbal indicators of injection pain was found when the DentiPatch was used 20%: compared to a 1 minute application of topical anesthetic gel. However, no significant difference was found between the two study groups in either reported pain or observed pain-motor responses.