Breaking Barriers in Paediatric Pain Management: Combined Cryotherapy and Vibration Therapy Vs. Audio-visual Aids for Alleviating Discomfort during Inferior Alveolar Nerve Block Administration in Children - a Randomized Controlled Study

Background: Behavioural and pain management in paediatric dental procedures, especially during the administration of an inferior alveolar nerve block, can be challenging due to the common occurrence of fear and anxiety in these scenarios. Diverse distraction techniques are deployed to alleviate the discomfort stemming from needle insertion, including the utilization of audiovisual aids, cold temperature and vibrations. Recently, there has been growing interest in the synergistic application of cryotherapy and vibration therapy, offering a promising alternative approach in this domain. Aim: The primary objective of this study was to investigate the effectiveness of combined cryotherapy and vibration therapy in alleviating pain during inferior alveolar nerve block (IANB) administration in children, with a comparison to the use of audiovisual aids. Methods: A randomized controlled trial was conducted on children aged five to twelve years requiring inferior alveolar nerve block (IANB) administration. 60 Children meeting the inclusion criteria were randomly divided into three groups: control, audio-visual aid group, and combined therapy group. Each group received either no intervention audio-visual aid or combined cryotherapy and vibration therapy respectively. Throughout the administration of the IANB, the behavioural response was evaluated using the Faces Legs Activity Cry Consolability Scale (FLACC), while the severity of pain was assessed using the Wong-Baker FACES Pain Rating Scale (WBFS). Results: The mean WBFS score of control group, combined cryotherapy and vibration therapy group and audiovisual intervention group were 4.70 ± 2.8, 2 ±1.9, 4.20 ±2.8 respectively. The combined use of ice pack and vibrating device had statistically significant impact on pain intensity reduction. The comparison was found to be statistically significant with P value <0.05. Conclusion: The study revealed that the combination of cryotherapy and vibration therapy yielded superior results compared to the use of audiovisual aids, demonstrating statistically significant outcomes.