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Nociception associated with pain/distress in young children sedated for dental treatment: a clinical study with objective and subjective measures

  • Original Scientific Article
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European Archives of Paediatric Dentistry Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the association between children’s pain/distress levels and patient characteristics (age, sex, history of dental pain), sedation type (level of sedation, sedative regimen), nociception and pain intensity reported by the parents in sedated children undergoing minimally invasive dental treatment.

Methods

This clinical study evaluated secondary outcomes of an RCT that evaluated the efficacy of dexmedetomidine sedation with or without ketamine. Only children who had nociception levels recorded using the Analgesia Nociception Index (ANI) were included (0–100; 0 = highest nociception). FLACC scale (Face, Legs, Activity, Cry and Consolability) was used to assess children’s pain/distress (0–10; 0 = no pain/distress). Parental proxy report of the child’s pain intensity during the treatment was performed using the Visual Analogue Scale (VAS; 0–100; 0 = no pain). The association between ANI, children’s age and sex, dental pain history, sedation level, sedative regimen, and VAS with the FLACC was verified using the generalised estimation equation analysis (alpha 0.05).

Results

Participants were 31 children (51.6% boys) and their parents (90.3% mothers). Median FLACC was 3.3 (25th–75th percentiles 1.7–8.2), ANI 80.9 (74.7–85.8), and VAS 10 (1–23). FLACC associated with ANI (OR 0.96; 95% CI 0.93–0.99; p = 0.02), moderate sedation (0.13; 0.03–0.50; p = 0.003), and VAS (1.05; 1.01–1.10; p = 0.01).

Conclusion

Pain/distress was generally low and more prominent with minimal (versus moderate) sedation and higher nociception.

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Data availability

Data are available on request from the authors.

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Acknowledgements

This study was funded by the Foundation for Research Support of the State of Goiás (Fundação de Amparo à Pesquisa do Estado de Goiás—FAPEG), Process number 201710267000525. Three authors (PCF, LGA and LRC) received research grants from the National Council for Scientific and Technological Development (CNPq) and the Coordination of Improvement of Higher Education Personnel (CAPES). The authors thank the Pediatric Dental Clinic research group (COP), which helped collect data.

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DAB, PCF, AAA, LGA and LRC conceived the ideas. DAB, AAA and PCF collected the data. DAB, PCF and LRC analysed the data. DAB led the writing. DAB, PCF, AAA, LGA, and LRC read and approved the final version of the manuscript.

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Correspondence to D. A. Baroni.

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Baroni, D.A., Corrêa-Faria, P., Anabuki, A.A. et al. Nociception associated with pain/distress in young children sedated for dental treatment: a clinical study with objective and subjective measures. Eur Arch Paediatr Dent 24, 255–262 (2023). https://doi.org/10.1007/s40368-023-00782-6

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