Painless dental extraction in children.

A controlled investigation was undertaken to compare topical lignocaine and rectal paracetamol in the prevention of pain after day case dental extraction in children under general anaesthesia. Sixty patients were allocated randomly to receive intraoperatively either topical lignocaine 4 mg/kg (group A), rectal paracetamol 10 mg/kg (group B) or no analgesia (group C) immediately after completion of surgery. Pain, appearance and side-effects were assessed 15, 30 and 60 minutes postoperatively. The patients who received topical lignocaine (group A) had significantly lower pain scores at 15 minutes (p < 0.001) and 30 minutes (p < 0.01) with no need for postoperative analgesia. The use of topical lignocaine was associated with a significantly (p < 0.01) more rapid return to a calm awake appearance at 15 and 30 minutes postoperatively. Patients in group C who received no analgesia at the end of the operation received 10 mg/kg acetyl salicylic acid intramuscularly after their return to the ward. No significant differences in the incidence of nausea, vomiting, or any other toxic reaction were found between the three groups. The improved analgesia and shorter recovery period topical lignocaine render it more satisfactory for the prevention of pain after day dental extraction in children than the more commonly used rectal paracetamol.