Pain and anxiety associated with Computer-Controlled Local Anaesthesia: Systematic review and meta-analysis of cross-over studies

Aim This review focuses on Computer-Controlled Local Anaesthesia Delivery systems (CCLAD), in comparison with conventional carpule anaesthesia in means of pain and anxiety. Methods Medline, Embase, Web of Science and Cochrane Database for Systematic Reviews were searched up to August 2018. Only cross-over splitmouth design studies aimed to clinically compare CCLAD with a conventional carpule anaesthesia are included. Data about pain and anxiety associated with anaesthesia were sought. The authors performed metaanalysis where appropriate. Results A total of 20 studies are included in the systematic review (n = 973 subjects). Quantitative synthesis (conducted on VAS scores from 8 studies) shows that pain intensity is over 9 points lower in CCLAD than in conventional anaesthesia on a scale from 0 to 100 (95% confidence interval, -12.90 to -5,53; P < .001). The systematic review showed no differences between the two techniques according to the physiological parameters of pain (heart rate or blood pressure), and the data about anxiety are inconsistent. Conclusion CCLAD results in significantly slightly less pain perception with respect to conventional injection and is a promising device to help patients. The literature needs to be expanded, mostly regarding anxiety.