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Alkalinizing local anesthetic does not decrease pain during injection for dorsal penile nerve block.

F Serour1, A Levine, A Mandelberg

  • 1Department of Pediatrics, Edith Wolfson Medical Center, Holon, Israel. fhserour@yahoo.com

Journal of Clinical Anesthesia
|January 7, 2000
PubMed
Summary
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Alkalinizing local anesthetic with sodium bicarbonate did not significantly reduce pain during penile nerve blocks for circumcision. This study found no difference in pain scores when using buffered lidocaine and bupivacaine solutions.

Area of Science:

  • Anesthesiology
  • Pain Management
  • Urology

Background:

  • Pain during local anesthetic infiltration can be a significant issue.
  • Alkalinizing local anesthetics with sodium bicarbonate is proposed to reduce injection pain.
  • Dorsal penile nerve blocks are commonly used for circumcision anesthesia.

Purpose of the Study:

  • To determine if alkalizing local anesthetic solutions with sodium bicarbonate reduces pain during infiltration for dorsal penile nerve blocks.
  • To compare pain levels associated with different pH levels of local anesthetic mixtures.

Main Methods:

  • Prospective, randomized, double-blind, controlled study involving 144 patients.
  • Patients received penile blocks with lidocaine and bupivacaine mixtures at varying pH levels (6.3, 6.9, 7.16, 7.43) achieved with sodium bicarbonate.

Related Experiment Videos

  • Pain was assessed using a subjective pain scale by blinded physicians.

    • Main Results:

    • Mean pain scores were similar across all groups, ranging from 1.94 to 2.3.
    • No statistically significant differences in pain were observed between the control group and groups receiving alkalized solutions.
    • The addition of sodium bicarbonate to achieve higher pH levels did not alter the pain experience.

    Conclusions:

    • Alkalinizing local anesthetic solutions with sodium bicarbonate does not decrease pain associated with infiltration during penile nerve blocks for circumcision.
    • The pH modification of lidocaine-bupivacaine mixtures did not yield a clinically relevant reduction in injection pain.
    • Further research may explore alternative methods for pain reduction during local anesthetic administration.