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Comparative Effectiveness of 20% Benzocaine Versus 2% Lignocaine Topical Gel in Reducing Needle-Puncture Pain During Local Anesthetic Infiltration

Muhammad Usama1, Abid Ashar2, Malik Ali Hassan Sajid3, Muhammad Asad Hayat4
1Oral and Maxillofacial Surgery, FMH College of Medicine and Dentistry, Shadman Rd, Ichhra Lahore, Pakistan
2Principal FMH college of Dentistry and Head of Department Oral and Maxillofacial Surgery, Shadman Rd, Ichhra Lahore, Pakistan
3Head of Oral and Maxillofacial Surgery Department, King Edward Medical University (KEMU)/Mayo Hospital Lahore, Pakistan
4Senior Medical Officer Cancer care hospital and research centre, Raiwind Road, Lahore, Pakistan
DOI: https://doi.org/10.70517/revcc2624160
Published: 15/10/2026
: Muhammad Usama, Abid Ashar, Malik Ali Hassan Sajid, Muhammad Asad Hayat. Comparative Effectiveness of 20% Benzocaine Versus 2% Lignocaine Topical Gel in Reducing Needle-Puncture Pain During Local Anesthetic Infiltration. Revista Cultura Científica, 2026 Issue 24. pg. 1909-1919.

Abstract

Pain associated with local anesthetic (LA) injections, including needle penetration and solution deposition, contributes to dental anxiety and reluctance to undergo dental treatment. Topical anesthetics are widely applied before injection to reduce procedural discomfort, although their relative effectiveness varies with the agent, formulation, concentration, application time, and injection site. This study compared the effectiveness of 20% benzocaine gel and 2% lignocaine gel in reducing pain during needle penetration and subsequent local anesthetic deposition in dental procedures. A non-randomized, parallel-group controlled trial was conducted in the Department of Oral and Maxillofacial Surgery, Fatima Memorial Hospital, Lahore, from March to July 2026. A total of 102 adults aged 18–60 years with American Society of Anesthesiologists (ASA) physical status I or II were included, with 51 participants receiving 20% benzocaine gel (Group A) and 51 receiving 2% lignocaine gel (Group B). Topical preparations were applied before standardized infiltration with an injectable local anesthetic solution. Pain was assessed using the Visual Analogue Scale (VAS) and Wong–Baker FACES Scale (WBS) at both needle insertion and LA solution deposition, as reported in the study tables. Compared with the lignocaine group, the benzocaine group had lower mean VAS scores during needle insertion (1.12 ± 0.84 versus 2.85 ± 1.42) and LA deposition (1.86 ± 1.10 versus 3.41 ± 1.68). Wong–Baker FACES scores were also lower at needle insertion (0.94 ± 0.76 versus 2.61 ± 1.35) and solution deposition (1.65 ± 0.98 versus 3.18 ± 1.54); all four reported between-group comparisons were statistically significant (p < 0.001). Under the conditions of this single-center, non-randomized study, 20% benzocaine gel was associated with lower needle-puncture and LA-deposition pain scores than 2% lignocaine gel. Randomized studies using documented allocation procedures and standardized pain measurements are warranted to confirm the comparative effectiveness and broader applicability of these findings.

Keywords: benzocaine; lignocaine; local anesthesia; needle-puncture pain; topical anesthetic gel; dental extraction; infiltration anesthesia

Abstract

Pain associated with local anesthetic (LA) injections, including needle penetration and solution deposition, contributes to dental anxiety and reluctance to undergo dental treatment. Topical anesthetics are widely applied before injection to reduce procedural discomfort, although their relative effectiveness varies with the agent, formulation, concentration, application time, and injection site. This study compared the effectiveness of 20% benzocaine gel and 2% lignocaine gel in reducing pain during needle penetration and subsequent local anesthetic deposition in dental procedures. A non-randomized, parallel-group controlled trial was conducted in the Department of Oral and Maxillofacial Surgery, Fatima Memorial Hospital, Lahore, from March to July 2026. A total of 102 adults aged 18–60 years with American Society of Anesthesiologists (ASA) physical status I or II were included, with 51 participants receiving 20% benzocaine gel (Group A) and 51 receiving 2% lignocaine gel (Group B). Topical preparations were applied before standardized infiltration with an injectable local anesthetic solution. Pain was assessed using the Visual Analogue Scale (VAS) and Wong–Baker FACES Scale (WBS) at both needle insertion and LA solution deposition, as reported in the study tables. Compared with the lignocaine group, the benzocaine group had lower mean VAS scores during needle insertion (1.12 ± 0.84 versus 2.85 ± 1.42) and LA deposition (1.86 ± 1.10 versus 3.41 ± 1.68). Wong–Baker FACES scores were also lower at needle insertion (0.94 ± 0.76 versus 2.61 ± 1.35) and solution deposition (1.65 ± 0.98 versus 3.18 ± 1.54); all four reported between-group comparisons were statistically significant (p < 0.001). Under the conditions of this single-center, non-randomized study, 20% benzocaine gel was associated with lower needle-puncture and LA-deposition pain scores than 2% lignocaine gel. Randomized studies using documented allocation procedures and standardized pain measurements are warranted to confirm the comparative effectiveness and broader applicability of these findings.

Keywords: benzocaine; lignocaine; local anesthesia; needle-puncture pain; topical anesthetic gel; dental extraction; infiltration anesthesia

References

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Muhammad Usama
Oral and Maxillofacial Surgery, FMH College of Medicine and Dentistry, Shadman Rd, Ichhra Lahore, Pakistan
usamasaeed23021999@gmail.com
Abid Ashar
Principal FMH college of Dentistry and Head of Department Oral and Maxillofacial Surgery, Shadman Rd, Ichhra Lahore, Pakistan
Malik Ali Hassan Sajid
Head of Oral and Maxillofacial Surgery Department, King Edward Medical University (KEMU)/Mayo Hospital Lahore, Pakistan
Muhammad Asad Hayat
Senior Medical Officer Cancer care hospital and research centre, Raiwind Road, Lahore, Pakistan

How to cite:

Muhammad Usama, Abid Ashar, Malik Ali Hassan Sajid, Muhammad Asad Hayat. Comparative Effectiveness of 20% Benzocaine Versus 2% Lignocaine Topical Gel in Reducing Needle-Puncture Pain During Local Anesthetic Infiltration. Revista Cultura Científica, 2026 Issue 24. pg. 1909-1919.

Publication History

  • Received: 25/07/2026
  • Accepted: 28/09/2026
  • Published: 15/10/2026
Copyright © 2026, Muhammad Usama, Abid Ashar, Malik Ali Hassan Sajid, Muhammad Asad Hayat. Published by Revista Cultura Científica. This article is published as open access under the Creative Commons Attribution 4.0 International (CC BY 4.0) license (http://creativecommons.org/licenses/by/4.0/).

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