Pre-emptive Local Anesthesia and Emergence Behavior After Pediatric Dental General Anesthesia (PEDLA-QOR)

May 20, 2026 updated by: seher orbay yasli

Effects of Pre-emptive Local Anesthesia on Emergence Behavior and Early Recovery Quality After Ambulatory Pediatric Dental General Anesthesia: A Parallel-Group Randomized Controlled Trial

This study will evaluate whether pre-emptive local anesthesia improves early recovery after ambulatory pediatric dental general anesthesia. Children aged 7-12 years scheduled for dental treatment under general anesthesia will be randomly assigned to receive either pre-emptive local anesthesia or no local anesthesia. Emergence behavior, pain, sedation level, and recovery quality will be assessed during the early postoperative period. The primary outcome will be the longitudinal emergence behavior score during the first 30 minutes in the post-anesthesia care unit.

Study Overview

Detailed Description

This is a prospective, single-center, assessor-blinded, parallel-group randomized controlled trial in children aged 7-12 years undergoing ambulatory dental treatment under general anesthesia.

Participants will be randomized in a 1:1 ratio to one of two groups: pre-emptive local anesthesia or no local anesthesia. In the pre-emptive local anesthesia group, local anesthesia will be administered by the pediatric dentist before the dental procedure according to the planned treatment area. In the no local anesthesia group, local anesthesia will not be routinely administered. If clinically required, rescue analgesia or additional local anesthesia may be administered at the discretion of the responsible clinician and will be recorded.

Preoperative anxiety will be assessed using the modified Yale Preoperative Anxiety Scale. In the post-anesthesia care unit, sedation and arousal will be assessed using the Richmond Agitation-Sedation Scale before each behavioral and pain assessment. Emergence behavior will be evaluated using a PAED-derived 3-item emergence behavior assessment at 0, 5, 10, 15, and 30 minutes after arrival in the post-anesthesia care unit, only when the child meets predefined arousal criteria. Pain will be assessed using the Faces Pain Scale-Revised at the same time points. Recovery quality before discharge will be assessed using the QoR-15 Pictorial form.

The study aims to determine whether reducing peri-emergence nociceptive input with pre-emptive local anesthesia improves early emergence behavior, postoperative pain, and recovery quality in children undergoing ambulatory dental general anesthesia.

Study Type

Interventional

Enrollment (Estimated)

80

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Seher Orbay Yaşlı, Assistant Professor of Anesthe
  • Phone Number: +905052401933
  • Email: sehersin81@hotmail.com

Study Locations

    • Kayseri
      • Kayseri, Kayseri, Turkey (Türkiye), 38039
        • Erciyes University Faculty of Dentistry
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Children aged 7 to 12 years
  • ASA physical status I or II
  • Scheduled for ambulatory dental treatment under general anesthesia
  • Ability to understand and respond to age-appropriate pain and recovery assessment tools
  • Written informed consent obtained from a parent or legal guardian
  • Child assent obtained when appropriate

Exclusion Criteria:

  • Known allergy or contraindication to local anesthetic agents
  • Developmental delay or cognitive impairment preventing assessment
  • Autism spectrum disorder or severe behavioral disorder
  • Neurological disease affecting behavior or consciousness
  • Chronic analgesic or sedative medication use
  • Severe hepatic, renal, cardiac, or respiratory disease
  • Emergency dental procedure
  • Need for postoperative hospital admission
  • Inability to complete postoperative assessment tools

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Pre-emptive Local Anesthesia
Children randomized to this group will receive pre-emptive local anesthesia administered by the pediatric dentist before the dental procedure under general anesthesia.
Pre-emptive local anesthesia will be administered by the pediatric dentist before the dental procedure according to the planned treatment area. The local anesthetic agent, total volume, total dose, dose per kilogram, and injection sites will be recorded.
Pre-emptive local anesthesia will be administered by the pediatric dentist before the dental procedure according to the planned treatment area. The local anesthetic agent, total volume, total dose, dose per kilogram, and injection sites will be recorded.
Articaine hydrochloride with epinephrine will be administered as local anesthesia by the pediatric dentist before the dental procedure in participants randomized to the pre-emptive local anesthesia group. The total volume, total dose, dose per kilogram, and injection sites will be recorded.
No Intervention: No Local Anesthesia
Children randomized to this group will undergo dental treatment under general anesthesia without routine pre-emptive local anesthesia. Rescue analgesia or additional local anesthesia may be administered if clinically required and will be recorded.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Emergence Behavior Score During the First 30 Minutes in the Post-Anesthesia Care Unit
Time Frame: PACU minutes 0, 5, 10, 15, and 30
Emergence behavior will be assessed using a PAED-derived 3-item emergence behavior assessment including eye contact, purposeful behavior, and awareness of surroundings. Each item is scored from 0 to 4, with a total score ranging from 0 to 12. Higher scores indicate greater emergence behavior disturbance. Assessments will be performed only when the Richmond Agitation-Sedation Scale score is ≥ -1.
PACU minutes 0, 5, 10, 15, and 30

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative Pain Score
Time Frame: PACU minutes 0, 5, 10, 15, and 30
Pain will be assessed using the Faces Pain Scale-Revised. Scores range from 0 to 10, with higher scores indicating greater pain intensity.
PACU minutes 0, 5, 10, 15, and 30
Recovery Quality Before Discharge
Time Frame: Before discharge on day of surgery
Recovery quality will be assessed using the QoR-15 Pictorial form before discharge. The total score ranges from 0 to 150, with higher scores indicating better postoperative recovery quality.
Before discharge on day of surgery

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

June 1, 2026

Primary Completion (Estimated)

December 1, 2026

Study Completion (Estimated)

December 1, 2026

Study Registration Dates

First Submitted

May 14, 2026

First Submitted That Met QC Criteria

May 20, 2026

First Posted (Actual)

May 22, 2026

Study Record Updates

Last Update Posted (Actual)

May 22, 2026

Last Update Submitted That Met QC Criteria

May 20, 2026

Last Verified

May 1, 2026

More Information

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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