Background and Objectives. To assess the efficacy of infiltration analgesia with local anesthetic in reducing postoperative distress and pain in children having dental extractions under general anesthesia.

Methods. Randomized, controlled, double-blind trial. One hundred children aged 3 to 14 years requiring one or more dental extractions under general anesthesia were recruited. Those randomized to receive local anesthetic had the periapical area of each tooth for extraction infiltrated with prilocaine 3% and felypressin (0.03 U/mL).

Results. Those receiving local anesthetic infiltration were less likely to be distressed than those receiving general anesthesia alone (P = .0001 on awakening, P = .0003 before discharge). Age and number of teeth extracted were also highly significant determinants of distress. In this study, the visual analog scale for pain severity was not useful because children in distress were less likely to complete this form of assessment (P < .001).

Conclusion. Prilocaine infiltration analgesia reduces early postoperative distress after dental extractions under general anesthesia. Further work is required to investigate the many potential benefits of infiltration analgesia.