Effect of Needle Gauge on Children's Pain and Anxiety Level During Palatal Infiltration Anesthesia Injection: A Triple-Blind Randomized Controlled Trial Study

Introduction: Pain of anesthesia injection in children is necessary and one of the most painful local anesthetics is palatal infiltration anesthesia.So, the purpose of this study was to compare the effect of needle gauge on pain and anxiety during palatal infiltration anesthesia injection in children 4-8 years.Methods: This triple-blind cross-over clinical trial study was performed on 60 children 4-8 years candidates for pulpotomy and SSC treatment of both maxillary first molar teeth.Based on the sequence of using 27-and 30-gauge needles, children were treated during 2 sessions.The anxiety level of children during palatal infiltration local anesthesia was measured using pulse rate (PR) and the pain level of patients was measured using SEM and FPR (objective and subjective criteria).Results: Anxiety during palatal anesthesia injection with gauge 27 was higher than gauge 30 (treatment effect < 0.001).In subjective and objective criteria, the injection pain in the palatal mucosa with a 27-gauge needle was higher than 30-gauge needle (treatment effect < 0.001).There was no significant difference between earlier and later injection of palatal infiltration with different gauges during treatment sessions (P < 0.05) and according to 0.021 for the period effect, it can be said that the period of receiving two needle gauges had an effect on the average heart rate difference.Conclusions: The pain of injection in the palatal mucosa with a 27-gauge needle is higher than with a 30-gauge needle, and the use of a 30-gauge needle in the palatal injection of children 4-8 years causes less discomfort than a 27-gauge needle.