Evaluating The Effectiveness of Pressure Application in Modulating Pain Response During Local Anesthetic Delivery: A Behavioral Approach to Enhance Patient Comfort

Abstract

Aim: The study aimed to compare the efficacy of Acupressure and Local pressure application technique in reducing pain perception during Greater palatine nerve block (GPNB) administration in children.

Methodology: A randomized, controlled, split-mouth crossover trial was conducted with 24 healthy children aged 6-9 years requiring bilateral GPNB. Participants were randomized to receive either acupressure using an Aculief device at the LI4 point for 3 minutes (Group A) or light pressure with a cotton bud at the injection site for 2 minutes (Group B) prior to the first GPNB. Interventions were switched at the second visit after a minimum 3-day washout period. The primary outcome was subjective pain measured using the Wong-Baker Faces Pain Rating Scale (WBS). The secondary outcome was objective behavioral pain assessed via the Sound, Eye, and Motor (SEM) scale by a blinded examiner. Data was analyzed using independent t-tests in SPSS version 23.

Results: The mean WBS score was significantly lower in Group A compared to Group B (2.67 vs. 4.58, p ≤ 0.000). Similarly, the mean total SEM score was significantly lower in Group A (4.42 vs. 7.71, p ≤ 0.000), with significant reductions in all individual SEM components. The results indicate that acupressure was associated with lower self-reported pain and more favorable observed behavior during injection.

Conclusion: Acupressure at the LI4 point is significantly more effective than local pressure application in reducing both subjective pain perception and negative behavioral responses during greater palatine nerve block administration in children aged 6-9 years.