Comparative Evaluation of Clinical Anaesthetic Efficacy of 15 % Lidocaine Spray and 20 % Benzocaine Gel during Removal of Arch Bars

BACKGROUND Application of arch bar is considered as a gold standard for intermaxillary fixation (IMF) in the management of mandibular fractures. Both the application and removal of arch bars can inflict pain for patients who require IMF. For removal of the arch bars, local anaesthesia (local infiltration or conduction block) is often indicated. The study aimed at comparing and validating the efficacy of topical lidocaine spray and benzocaine gel in patients undergoing removal of arch bars. METHODS 30 subjects were included in this prospective randomized controlled trial. Maxillary arch was chosen as the test site. 10 patients (Group A) were anaesthetized in the upper gingiva with 15 % lidocaine spray and remaining 10 patients (Group B) were anaesthetized with 20 % benzocaine gel, following which removal of arch bar was done. 10 patients were included in the control group (Group C) where 2 % lignocaine infiltration was offered only on request. Visual analog scale and Wong-Baker Faces Pain Rating Scale was used to measure the pain perceived by the patient during the procedure. RESULTS The mean and standard deviation of the pain scores of Group A was 2.5 +/- 0.70, Group B was 2.7 +/- 0.67 and Control group was 5.5 +/- 0.85. Both the test groups had a significant pain reduction when compared with the control group. CONCLUSIONS Topical application of both 15 % lidocaine spray and 20 % benzocaine gel provided equally efficient analgesia and can be useful alternatives to conventional local anaesthetic infiltration during arch bar removal.