**7. New techniques**


**Figure 10.** SYRIJET needle-free injection.

**1. Computer controlled injection:** In this technique, computer controls the speed and injection pressure. C-CLADS (computer controlled local anesthetic delivery system) has less pain and discomfort for patients than conventional syringe injections, but requires greater facilities, more space and higher costs [1].

**6. Drug Combination:** The combination of local anesthetic drugs with systemic analgesic drugs such as morphine can reduce the amount of pain during and after the surgery [33]. In general, the combination of opioid with anesthetic drugs reduces the need for analgesics after surgery and increases the duration of anesthesia but has side effects such as nausea and vomiting. The combination of alpha-2 adrenergic agonists such as clonidine, espe‐ cially with medium-acting anesthetic medications, increases the potential of these drugs. The drug side effects include bradycardia, hypotension and dryness of the mouth, which of course are caused by doses greater than 2 micrograms per kilogram. Ketamine, midazolam and magnesium can increase the power of anesthetic drugs but they must also be considered for their neurotoxic properties. Symptoms such as hallucination and

**1. Electronic dental anesthesia (EDA):** This technique is based on the TENS (transcutaneous electronic nerve stimulation) and the electronic waves are used to disrupt neural pain transmission to the brain. Research on this technique continues for use in the dental field

**2. Needle-free injection:** The injection system is based on a piston-pressure system and several systems are introduced such as PED-O-JET, SYRIJET and MED-E-JET. These techniques are widely used for daily injections of insulin in diabetics. In studies, these systems showed less pain compared to conventional injections with a needle gauge of 25

**1. Computer controlled injection:** In this technique, computer controls the speed and injection pressure. C-CLADS (computer controlled local anesthetic delivery system) has

sedation occur following the use of these drugs [34].

20 A Textbook of Advanced Oral and Maxillofacial Surgery Volume 2

**7. New techniques**

(Figure 10).[1]

**Figure 10.** SYRIJET needle-free injection.

[1].


**Figure 11.** Transcutaneous electronic nerve stimulation
