Aim: To evaluate pain perception by using Lignocaine and Midazolam as topical anaesthetic agents prior to inferior alveolar nerve block in 3–11 year old children undergoing pulpectomy procedures

Introduction:
Inferior alveolar nerve block (IANB) is one of the most commonly used local anaesthesia techniques in paediatric dentistry but remains highly anxiety-provoking and painful for children. Conventional topical anaesthetics, primarily Lignocaine, provide only partial relief. Midazolam, a benzodiazepine with sedative and anxiolytic properties, has recently been explored for its potential topical anaesthetic effect on oral mucosa.

Methodology:
A randomized controlled clinical trial was conducted on 80 children aged between 3–11 years requiring pulpectomy[Ma1]  in mandibular primary molars. Participants were randomly assigned into two groups: Group A ( Lignocaine spray ) and Group B (Midazolam spray ) applied for a minute before IANB. Pain perception during injection was assessed using the SEM scale. The time until the area was anesthetized was also measured in minutes.

Results:
Children in the Midazolam group demonstrated significantly lower pain scores on SEM scale when compared with Lignocaine group. Also there were no post-anaesthetic complications in any of the children.

Conclusion:
Thus, topical Midazolam demonstrated superior efficacy compared to Lignocaine in reducing pain and anxiety during IANB in young children. Its dual action as a topical anaesthetic and anxiolytic makes it a promising adjunct for paediatric dentistry.