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Neutralized lidocaine with epinephrine for local anesthesia--II.
J H Stewart1, S E Chinn, G W Cole
1Department of Dermatology, University of California, Irvine.
The Journal of Dermatologic Surgery and Oncology
|September 1, 1990
Summary
Adding sodium bicarbonate to lidocaine with epinephrine injections significantly reduces injection pain. This pH adjustment improves patient comfort without compromising anesthetic or vasoconstrictive effects, even with stored solutions.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Intradermal injections of lidocaine with epinephrine can cause significant pain.
- Pain is often attributed to the acidic nature of the anesthetic solution.
Purpose of the Study:
- To evaluate the pain-attenuating effects of buffering lidocaine with epinephrine.
- To assess the clinical efficacy and stability of buffered lidocaine solutions.
Main Methods:
- Prepared solutions of 1% lidocaine with epinephrine (1:100,000) and sodium bicarbonate (80 meq/L).
- Assessed pain, anesthesia, and vasoconstriction after intradermal infiltration.
- Compared freshly prepared solutions with those stored for one week.
Main Results:
- Sodium bicarbonate significantly attenuated the pain of lidocaine-epinephrine injections.
- Buffered solutions demonstrated comparable anesthetic and vasoconstrictive effects to non-buffered solutions.
- Stored buffered solutions maintained clinical efficacy for up to one week.
Conclusions:
- Buffering lidocaine with epinephrine using sodium bicarbonate effectively reduces injection pain.
- The pH adjustment is the likely mechanism for pain attenuation.
- Buffered lidocaine solutions are stable and clinically effective for at least one week.