3. Infiltration injection LA versus placebo or no treatment (7 studies).
| Lignocaine plus adrenaline | ||||
| Study | Outcome | Treatment | Comparator | Results |
| LA | Saline placebo | |||
| Coulthard 2006*+ | Pain (5‐face scale) waking | Mean 1.45 (1.38 sd) N = 70 | Mean 1.37 (1.32 sd) N = 69 | 0.08 (95% CI ‐0.37 to 0.53) P = 0.72 (t‐test) |
| Pain (5‐face scale) 30 minutes postoperatively | Mean 1.74 (1.44 sd) N = 70 | Mean 1.70 (1.32 sd) N = 69 | 0.04 (95% CI ‐0.42 to 0.50) P = 0.86 (t‐test) | |
| Pain (5‐face scale) 24 hours postoperatively | Mean 0.69 (1.10 sd) N = 70 | Mean 0.75 (1.23 sd) N = 69 | ‐0.06 (95% CI ‐0.45 to 0.33) P = 0.76 (t‐test) | |
| Distress (5‐category) on waking | Mean 2.24 (0.87 sd) N = 70 | Mean 2.20 (0.85 sd) N = 69 | 0.04 (95% CI ‐0.25 to 0.33) P = 0.78 (t‐test) | |
| Distress (5‐category) 30 minutes postoperatively | Mean 2.57 (0.83 sd) N = 70 | Mean 2.42 (0.74 sd) N = 69 | 0.15 (95% CI ‐0.11 to 0.41) P = 0.26 (t‐test) | |
| Lip or cheek biting 24 hours postoperatively | 3/70 | 1/69 | P = 0.62 (Fisher's exact test) | |
| Study | Outcome | Treatment | Comparator | Results |
| LA | No treatment | |||
| Watts 2009*+ | Heart rate | Mean 119.53 bpm (16.50 sd) for LA. n = 24 | Mean 124.38 bpm (16.45 sd) n = 24 | ‐4.85 (95% CI ‐14.42 to 4.72) P = 0.31 (t‐test) |
| End tidal CO2 | Mean 50.2 mm Hg (3.55 sd) n = 24 | Mean 47.46 mm Hg (4.16 sd) n = 24 | 2.74 (95% CI 0.49 to 4.99) P = 0.02 (t‐test) | |
| Respiratory rate | Mean 30.33 brpm (5.08 sd) n = 24 | Mean 32.08 brpm (5.50 sd) n = 24 | ‐1.75 (95% CI ‐4.83 to 1.33) P = 0.26 (t‐test) | |
| Townsend 2009+ | Pain (Wong‐Baker FACES® Pain Rating Scale, 6‐face scale) immediately postoperatively | N = 15 | N = 12 | Results not reported; authors 'did not use Wong‐Baker FACES immediately post‐operatively due to variable cooperation of subjects' |
| Pain (Wong‐Baker FACES® Pain Rating Scale, 6‐face scale) evening following surgery | Mean 0.30 (0.21) n = 10 | Mean 0.60 (1.35) n = 10 | P = 0.92 (Wilcoxon Rank Sum test) | |
| Distress (FLACC) closest to discharge | Mean 2.47 (2.69) n = 15 | Mean 2.58 (2.54) n = 12 | P = 0.88 (Wilcoxon Rank Sum test) | |
| Lip or cheek biting evening following surgery* | 4/11 | 1/12 | P = 0.16 (Fisher's exact test) | |
| McWilliams 2007+ | Pain (CHEOPS range 4 to 13) Assessment at 'period between when they awoke and when they were sufficiently recovered to leave for the discharge waiting area'. Exact time not specified | Median 6 (IQR 5 to 8) N = 38 | Median 6 (IQR 5 to 8.75) n = 38 | P = 0.99 (Mann Whitney U test) |
| Bleeding (suctioning for bleeding)* | 0/38 | 5/38 | P = 0.05 (Fisher's exact test) | |
| Al‐Bahlani 2001 | Pain (TPPPS) 11‐minute period of observation | Mean rank 63.96 n = 50 | Mean rank 37.07 n = 50 | P < 0.0001 (Mann Whitney U Test) |
| Bleeding (collection of 'all the aspirated fluids and used swabs')* | Mean total blood loss per root 0.79 (sd 0.06) n = 48 | Mean total blood loss per root 1.19 (sd 0.1) n = 50 | ‐0.4 (95% CI ‐0.43 to ‐0.37) P < 0.0001 (t‐test) (2 outlying values removed 6.16 and 3.96) | |
| Lignocaine alone | ||||
| Study | Outcome | Treatment | Comparator | Results |
| LA | Placebo | |||
| Rashad 1990*+ | Postoperative pain (presence or absence) | 21/50 | 36/50 | P = 0.004 (Fisher's exact test) |
| Maximum pulse rate during surgery | Mean 83.3 (9.6 sd) n = 50 | Mean 99.6 (14.1 sd) n = 50 | ‐16.3 (95% CI ‐21.09 to ‐11.51) P < 0.001 (t‐test) | |
| End tidal CO2 postoperative | Mean 39.8 nn Hg (3.8) n = 50 | Mean 38.8 mmHg (4.2 sd) n = 50 | 1.0 (95% CI ‐0.59 to 2.59) P = 0.21 | |
| Volume of GA (halothane) delivered | Mean 0.86% (0.28 sd) n = 50 | Mean 1.73% (0.03 sd) n = 50 | ‐0.87 (95% CI ‐0.95 to ‐0.79) P < 0.001 (t‐test) | |
| Incidence of perioperative cardiac dysrhythmias | 1/50 | 14/50 | P < 0.001 (Fisher's exact test) | |
| Prilocaine plus felypressin | ||||
| Study | Outcome | Treatment | Comparator | Results |
| LA | No treatment | |||
| Noble 1994* | Distress (4‐point scale: high score = high distress) on wakening | Median 2 (1 to 2 IQR) n = 57 | Median 3 (2 to 4 IQR) n=43 | P = 0.007 (Mann Whitney U test) |
| Distress (4‐point scale: high score = high distress) before discharge | Median 2 (1 to 3 IQR) n = 57 | Median 2 (2 to 3 IQR) n = 43 | P = 0.03 (Mann Whitney U test) | |
| Pain (VAS) | N = 30 completed VAS (57 randomised) | N = 23 completed VAS (43 randomised) | Authors reported 'distressed children were significantly less likely to complete this method of assessment' | |
CHEOPS = Children's Hospital of Eastern Ontario Pain Scale. CI = confidence interval. CO2 = carbon dioxide. FLACC = Faces Legs Activity Crying Consolability. GA = general anaesthesia. IQR = interquartile range LA = local anaesthetic. n = number. P = P value. *re‐analysis of reported data. SD = standard deviation. +studies where supplementary analgesics were given. TPPPS = Toddler Preschooler‐Postoperative Pain Scale. VAS = visual assessment scale.