Comparison of Aculief Acupressure and Lidocaine Ice Button for Reducing Pain during Dental Injection in Children

INTERVENTION: Intervention1: lidocaine ice button: Lidocaine ice buttons will be prepared using disposable syringes that served as molds. After removing the needle hub, each syringe was filled with 2% lidocaine solution. The syringes were sealed and stored in a freezer until complete solidification of the solution occurred Immediately before use, a section of the syringe barrel will be cut to expose the frozen lidocaine. The frozen preparation will then be gently extruded with the aid of the syringe plunger. The resulting lidocaine ice button will be positioned directly over the intended injection site and kept in contact with the mucosa for one minute before administration of local anaesthesia. After completion of the assigned intervention, maxillary buccal infiltration anaesthesia will be administered using 2% lidocaine with 1:80,000 epinephrine delivered through a 26‐gauge needle following the standard infiltration technique. To maintain uniformity of the procedure and minimize operator‐dependent variations, all injections will be performed by a single trained operator. The anaesthetic solution will be deposited slowly over approximately one minute. Control Intervention1: aculief acupressure device: For the acupressure procedure, the Aculief device will be placed over the LI4 (Hegu) acupoint situated in the web space between the thumb and inde Xfinger on the hand opposite to the side selected for injection. Application of the device will be commenced approximately one minute before delivery of local anaesthesia and will be maintained throughout the injection process CONDITION: PRIMARY OUTCOME: to assess pain perceived by children during local anaesthesia administration using wong baker faces pain scaleTimepoint: before, after SECONDARY OUTCOME: To assess behavioural reactions exhibited during local anaesthetic injection using the Sound Eye Motor scale. To record physiological changes occurring during the procedure by measuring heart rate and peripheral oxygen saturation with a pulse oximeter. To compare the ability of Aculief acupressure and the Lidocaine Ice Button to reduce discomfort during maxillary buccal infiltration anaesthesia in pediatric patients.Timepoint: before after INCLUSION CRITERIA: Participants fulfilling the following criteria were included in the study: Healthy children between 6 and 10 years of age. Children requiring bilateral maxillary buccal infiltration anaesthesia for dental procedures such as pulpectomy or extraction. Children with no prior history of receiving local anaesthetic injections. Children exhibiting positive or definitely positive behaviour corresponding to Frankl Behaviour Rating Scale scores of 3 or 4.