{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T01:20:55Z","timestamp":1787707255099,"version":"build-2784847793"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":121,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Syst Rev"],"DOI":"10.1186\/s13643-026-03181-2","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T01:15:00Z","timestamp":1777252500000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The effectiveness of using local anesthesia with general anesthesia in pediatric dental rehabilitation: a systematic review and meta-analysis"],"prefix":"10.1186","volume":"15","author":[{"given":"Shimaa T.","family":"Ibrahim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doaa Y.","family":"Jamal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Y.","family":"Alzahrani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deem A.","family":"AlBlaihed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narmin M.","family":"Helal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9788-0379","authenticated-orcid":false,"given":"Heba Jafar","family":"Sabbagh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"3181_CR1","doi-asserted-by":"crossref","unstructured":"Al Baghdadi Z. Experiences of children undergoing dental treatment under general anesthesia: a qualitative study in Canada.\u00a0Al Baghdadi: Saskatoon, Saskatchewan, Canada: University of Saskatchewan; 2019.","DOI":"10.1542\/peds.144.2MA8.719"},{"issue":"6","key":"3181_CR2","doi-asserted-by":"publisher","first-page":"833","DOI":"10.4103\/njcp.njcp_1807_21","volume":"25","author":"HM Elkhodary","year":"2022","unstructured":"Elkhodary HM, Bagher SM, Sabbagh HJ, Almushayt A, Almalik M, Baghlaf K, et al. Factors relating to failure rates of dental procedures in children following comprehensive dental treatments under general anesthesia: a 2-year retrospective study. Niger J Clin Pract. 2022;25(6):833\u201340.","journal-title":"Niger J Clin Pract"},{"key":"3181_CR3","unstructured":"American Academy of Pediatrics, American Academy of Pediatric Dentistry. Guideline for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures. 2006. https:\/\/www.aapd.org\/assets\/1\/7\/G_Sedation.pdf. Accessed 14 Jan 2025."},{"issue":"11","key":"3181_CR4","doi-asserted-by":"publisher","DOI":"10.3390\/children10111776","volume":"10","author":"SM Bagher","year":"2023","unstructured":"Bagher SM, Sabbagh HJ, Nadhreen A, Alamoudi NM, Almushayt A, Al-Malik M, et al. Preference for comprehensive dental treatment under general anesthesia among parents with previous experience: a cross-sectional study. Children. 2023;10(11):1776.","journal-title":"Children"},{"issue":"3","key":"3181_CR5","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1016\/j.bpa.2005.01.004","volume":"19","author":"GA Mashour","year":"2005","unstructured":"Mashour GA, Forman SA, Campagna JA. Mechanisms of general anesthesia: from molecules to mind. Best Pract Res Clin Anaesthesiol. 2005;19(3):349\u201364.","journal-title":"Best Pract Res Clin Anaesthesiol"},{"issue":"3","key":"3181_CR6","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1213\/01.ANE.0000175214.38450.91","volume":"101","author":"DL Reich","year":"2005","unstructured":"Reich DL, Hossain S, Krol M, Baez B, Patel P, Bernstein A, et al. Predictors of hypotension after induction of general anesthesia. Anesth Analg. 2005;101(3):622\u20138.","journal-title":"Anesth Analg"},{"issue":"1","key":"3181_CR7","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/j.oooo.2018.08.002","volume":"127","author":"RG Salma","year":"2019","unstructured":"Salma RG, Abu-Naim H, Ahmad O, Akelah D, Salem Y, Midoun E. Vital signs changes during different dental procedures: a prospective longitudinal cross-over clinical trial. Oral Surg Oral Med Oral Pathol Oral Radiol. 2019;127(1):30\u20139.","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol"},{"key":"3181_CR8","doi-asserted-by":"crossref","unstructured":"Vuyk J. Drug interactions in anesthesia. In: Absalom A, Mason K, editors. Total intravenous anesthesia and target controlled infusions \"a comprehensive global anthology\".\u00a0Switzerland: Springer International Publishing; 2017. p. 313\u201325.","DOI":"10.1007\/978-3-319-47609-4_17"},{"issue":"4","key":"3181_CR9","doi-asserted-by":"publisher","first-page":"206","DOI":"10.2344\/anpr-68-02-06","volume":"68","author":"K Lipp","year":"2021","unstructured":"Lipp K, Casamassimo P, Griffen A, Smiley M, Bryant J, Draper J, et al. Effect of intrapapillary local anesthetic on postoperative pain following dental treatment under general anesthesia in pediatric patients. Anesth Prog. 2021;68(4):206\u201313.","journal-title":"Anesth Prog"},{"issue":"1","key":"3181_CR10","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1038\/sj.bdj.4813123","volume":"200","author":"MT Hosey","year":"2006","unstructured":"Hosey MT, Macpherson LM, Adair P, Tochel C, Burnside G, Pine C. Dental anxiety, distress at induction and postoperative morbidity in children undergoing tooth extraction using general anaesthesia. Br Dent J. 2006;200(1):39\u201343 discussion 27; quiz 50.","journal-title":"Br Dent J"},{"issue":"2","key":"3181_CR11","first-page":"111","volume":"30","author":"HL Needleman","year":"2008","unstructured":"Needleman HL, Harpavat S, Wu S, Allred EN, Berde C. Postoperative pain and other sequelae of dental rehabilitations performed on children under general anesthesia. Pediatr Dent. 2008;30(2):111\u201321.","journal-title":"Pediatr Dent"},{"issue":"1","key":"3181_CR12","first-page":"48","volume":"59","author":"G Acs","year":"1992","unstructured":"Acs G, Drazner E. The incidence of postoperative pain and analgesic usage in children. ASDC J Dent Child. 1992;59(1):48\u201352.","journal-title":"ASDC J Dent Child"},{"issue":"1","key":"3181_CR13","first-page":"52","volume":"35","author":"NM Staman","year":"2013","unstructured":"Staman NM, Townsend JA, Hagan JL. Observational study: discomfort following dental procedures for children. Pediatr Dent. 2013;35(1):52\u20134.","journal-title":"Pediatr Dent"},{"issue":"1","key":"3181_CR14","doi-asserted-by":"publisher","first-page":"11","DOI":"10.2344\/0003-3006-61.1.11","volume":"61","author":"JA Townsend","year":"2014","unstructured":"Townsend JA, Hagan JL, Smiley M. Use of local anesthesia during dental rehabilitation with general anesthesia: a survey of dentist anesthesiologists. Anesth Prog. 2014;61(1):11\u20137.","journal-title":"Anesth Prog"},{"issue":"3","key":"3181_CR15","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1097\/00000542-199209000-00006","volume":"77","author":"J Katz","year":"1992","unstructured":"Katz J, Kavanagh BP, Sandler AN, Nierenberg H, Boylan JF, Friedlander M, et al. Preemptive analgesia. Clinical evidence of neuroplasticity contributing to postoperative pain. Anesthesiology. 1992;77(3):439\u201346.","journal-title":"Anesthesiology"},{"issue":"12","key":"3181_CR16","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.1016\/j.ijom.2006.07.007","volume":"35","author":"P Coulthard","year":"2006","unstructured":"Coulthard P, Rolfe S, Mackie IC, Gazal G, Morton M, Jackson-Leech D. Intraoperative local anaesthesia for paediatric postoperative oral surgery pain--a randomized controlled trial. Int J Oral Maxillofac Surg. 2006;35(12):1114\u20139.","journal-title":"Int J Oral Maxillofac Surg"},{"issue":"4","key":"3181_CR17","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1111\/j.1365-263X.2007.00832.x","volume":"17","author":"HM Sammons","year":"2007","unstructured":"Sammons HM, Unsworth V, Gray C, Choonara I, Cherrill J, Quirke W. Randomized controlled trial of the intraligamental use of a local anaesthetic (lignocaine 2%) versus controls in paediatric tooth extraction. Int J Paediatr Dent. 2007;17(4):297\u2013303.","journal-title":"Int J Paediatr Dent"},{"issue":"2","key":"3181_CR18","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1046\/j.1365-263X.2003.00430.x","volume":"13","author":"S J\u00fcrgens","year":"2003","unstructured":"J\u00fcrgens S, Warwick RS, Inglehearn PJ, Gooneratne DS. Pain relief for paediatric dental chair anaesthesia: current practice in a community dental clinic. Int J Paediatr Dent. 2003;13(2):93\u20137.","journal-title":"Int J Paediatr Dent"},{"issue":"3","key":"3181_CR19","first-page":"181","volume":"41","author":"AM Moness Ali","year":"2019","unstructured":"Moness Ali AM, Hammuda AA. Local anesthesia effects on postoperative pain after pediatric oral rehabilitation under general anesthesia. Pediatr Dent. 2019;41(3):181\u20135.","journal-title":"Pediatr Dent"},{"issue":"1","key":"3181_CR20","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1111\/j.1365-263X.2004.00520.x","volume":"14","author":"S Atan","year":"2004","unstructured":"Atan S, Ashley P, Gilthorpe MS, Scheer B, Mason C, Roberts G. Morbidity following dental treatment of children under intubation general anaesthesia in a day-stay unit. Int J Paediatr Dent. 2004;14(1):9\u201316.","journal-title":"Int J Paediatr Dent"},{"issue":"5","key":"3181_CR21","first-page":"261","volume":"46","author":"S Al-Bahlani","year":"2001","unstructured":"Al-Bahlani S, Sherriff A, Crawford PJ. Tooth extraction, bleeding and pain control. J R Coll Surg Edinb. 2001;46(5):261\u20134.","journal-title":"J R Coll Surg Edinb"},{"issue":"3","key":"3181_CR22","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1046\/j.1365-2044.2002.2408_5.x","volume":"57","author":"J Andrzejowski","year":"2002","unstructured":"Andrzejowski J, Lamb L. The effect of swabs soaked in bupivacaine and epinephrine for pain relief following simple dental extractions in children. Anaesthesia. 2002;57(3):281\u20133.","journal-title":"Anaesthesia"},{"issue":"6","key":"3181_CR23","doi-asserted-by":"publisher","first-page":"844","DOI":"10.1016\/j.clinthera.2005.06.018","volume":"27","author":"K Anand","year":"2005","unstructured":"Anand K, Celeste C, Oberlander TF, Taddio A, Lehr VT, Walco GA. Analgesia and local anesthesia during invasive procedures in the neonate. Clin Ther. 2005;27(6):844\u201376.","journal-title":"Clin Ther"},{"issue":"12","key":"3181_CR24","first-page":"Cd009742","volume":"2014","author":"S Parekh","year":"2014","unstructured":"Parekh S, Gardener C, Ashley PF, Walsh T. Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for dental treatment in children and adolescents. Cochrane Database Syst Rev. 2014;2014(12):Cd009742.","journal-title":"Cochrane Database Syst Rev"},{"key":"3181_CR25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/2046-4053-4-1","volume":"4","author":"D Moher","year":"2015","unstructured":"Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4:1\u20139.","journal-title":"Syst Rev"},{"issue":"4","key":"3181_CR26","doi-asserted-by":"publisher","first-page":"W-65","DOI":"10.7326\/0003-4819-151-4-200908180-00136","volume":"151","author":"A Liberati","year":"2009","unstructured":"Liberati A, Altman DG, Tetzlaff J, Mulrow C, G\u00f8tzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med. 2009;151(4):W-65-W\u221294.","journal-title":"Ann Intern Med"},{"key":"3181_CR27","doi-asserted-by":"crossref","unstructured":"Higgins JP, Altman DG. Assessing risk of bias in included studies. Cochrane handbook for systematic reviews of interventions: Cochrane book series. 2008. pp. 187\u2013241.","DOI":"10.1002\/9780470712184.ch8"},{"issue":"1","key":"3181_CR28","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1080\/02739615.2020.1831389","volume":"50","author":"A Aljubour","year":"2021","unstructured":"Aljubour A, Abdelbaki MA, Elmeligy O, Al-Jabri B, Sabbagh H. Effectiveness of dental visual aids in behavior management of children with autism spectrum disorder: a systematic review. Child Health Care. 2021;50(1):83\u2013107.","journal-title":"Child Health Care"},{"issue":"3","key":"3181_CR29","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1002\/cre2.173","volume":"5","author":"RS Najjar","year":"2019","unstructured":"Najjar RS, Alamoudi NM, El-Housseiny AA, Al Tuwirqi AA, Sabbagh HJ. A comparison of calcium hydroxide\/iodoform paste and zinc oxide eugenol as root filling materials for pulpectomy in primary teeth: a systematic review and meta-analysis. Clin Exp Dent Res. 2019;5(3):294\u2013310.","journal-title":"Clin Exp Dent Res"},{"key":"3181_CR30","unstructured":"Skarda KS. The Effect of Local Anesthesia When Used in Dental Restorative Cases Under General Anesthesia on Control of Intraoperative Physiologic Parameters and Post-Operative Comfort.\u00a0Skarda: Richmond, Virginia, USA: VCU University; 2021."},{"issue":"1","key":"3181_CR31","first-page":"10","volume":"6","author":"P Anand","year":"2005","unstructured":"Anand P, Wilson R, Sheehy EC. Intraligamental analgesia for post-operative pain control in children having dental extractions under general anaesthesia. Eur J Paediatr Dent. 2005;6(1):10\u20135.","journal-title":"Eur J Paediatr Dent"},{"issue":"6","key":"3181_CR32","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1038\/bdj.2007.851","volume":"203","author":"KJ Leong","year":"2007","unstructured":"Leong KJ, Roberts GJ, Ashley PF. Perioperative local anaesthetic in young paediatric patients undergoing extractions under outpatient \u201cshort-case\u201d general anaesthesia. A double-blind randomised controlled trial. Br Dent J. 2007;203(6):334\u20135.","journal-title":"Br Dent J"},{"issue":"5","key":"3181_CR33","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1111\/j.1365-263X.2007.00841.x","volume":"17","author":"PA McWilliams","year":"2007","unstructured":"McWilliams PA, Rutherford JS. Assessment of early postoperative pain and haemorrhage in young children undergoing dental extractions under general anaesthesia. Int J Paediatr Dent. 2007;17(5):352\u20137.","journal-title":"Int J Paediatr Dent"},{"issue":"2","key":"3181_CR34","first-page":"126","volume":"19","author":"DW Noble","year":"1994","unstructured":"Noble DW, Raab GM, MacLean D, MacLachlan D. Prilocaine infiltration as postoperative analgesia for children having dental extractions under general anesthesia. Reg Anesth Pain Med. 1994;19(2):126\u201331.","journal-title":"Reg Anesth Pain Med"},{"issue":"4","key":"3181_CR35","doi-asserted-by":"publisher","first-page":"115","DOI":"10.2344\/0003-3006-56.4.115","volume":"56","author":"JA Townsend","year":"2009","unstructured":"Townsend JA, Ganzberg S, Thikkurissy S. The effect of local anesthetic on quality of recovery characteristics following dental rehabilitation under general anesthesia in children. Anesth Prog. 2009;56(4):115\u201322.","journal-title":"Anesth Prog"},{"issue":"5","key":"3181_CR36","first-page":"414","volume":"31","author":"AK Watts","year":"2009","unstructured":"Watts AK, Thikkurissy S, Smiley M, McTigue DJ, Smith T. Local anesthesia affects physiologic parameters and reduces anesthesiologist intervention in children undergoing general anesthesia for dental rehabilitation. Pediatr Dent. 2009;31(5):414\u20139.","journal-title":"Pediatr Dent"},{"issue":"3","key":"3181_CR37","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1007\/s40368-013-0081-0","volume":"15","author":"HY El Batawi","year":"2014","unstructured":"El Batawi HY. Factors affecting clinical outcome following treatment of early childhood caries under general anaesthesia: a two-year follow-up. Eur Arch Paediatr Dent. 2014;15(3):183\u20139.","journal-title":"Eur Arch Paediatr Dent"},{"key":"3181_CR38","unstructured":"Basak Keskin Y. Complications associated with local anesthesia in oral and maxillofacial surgery. In: V\u00edctor MW-L, Enrique H-C, editors. Topics in Local Anesthetics. Rijeka: IntechOpen; 2019."},{"issue":"1","key":"3181_CR39","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/0022-3999(67)90057-8","volume":"11","author":"H Merskey","year":"1967","unstructured":"Merskey H, Spear FG. The concept of pain. J Psychosom Res. 1967;11(1):59\u201367.","journal-title":"J Psychosom Res"},{"key":"3181_CR40","doi-asserted-by":"publisher","first-page":"S55","DOI":"10.1016\/0003-9969(94)90189-9","volume":"39","author":"PA McGrath","year":"1994","unstructured":"McGrath PA. Psychological aspects of pain perception. Arch Oral Biol. 1994;39:S55\u201362.","journal-title":"Arch Oral Biol"},{"issue":"6","key":"3181_CR41","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1111\/pan.13373","volume":"28","author":"M Vittinghoff","year":"2018","unstructured":"Vittinghoff M, L\u00f6nnqvist PA, Mossetti V, Heschl S, Simic D, Colovic V, et al. Postoperative pain management in children: guidance from the pain committee of the European Society for Paediatric Anaesthesiology (ESPA Pain Management Ladder Initiative). Pediatr Anesth. 2018;28(6):493\u2013506.","journal-title":"Pediatr Anesth"}],"container-title":["Systematic Reviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13643-026-03181-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13643-026-03181-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13643-026-03181-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:58:08Z","timestamp":1787705888000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s13643-026-03181-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,27]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3181"],"URL":"https:\/\/doi.org\/10.1186\/s13643-026-03181-2","relation":{},"ISSN":["2046-4053"],"issn-type":[{"value":"2046-4053","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,27]]},"assertion":[{"value":"22 April 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"234"}}