Buffered lidocaine for incision and drainage: a prospective, randomized double-blind study

Area of Science:

• Dentistry
• Anesthesiology
• Pain Management

Background:

• Buffered local anesthetics lack study for dental incision and drainage.
• Pulpal necrosis with acute swelling presents pain management challenges.

Purpose of the Study:

• To compare pain during infiltration and incision/drainage using buffered vs. non-buffered 2% lidocaine with epinephrine.
• Evaluate the efficacy of buffered lidocaine in reducing procedural pain.

Main Methods:

• Prospective, randomized, double-blind study with 81 adult patients.
• Comparison of buffered (sodium bicarbonate) vs. non-buffered 2% lidocaine with 1:100,000 epinephrine.
• Pain assessment via visual analog scale for infiltrations and the incision/drainage procedure.

Main Results:

• No significant difference in infiltration pain between buffered and non-buffered lidocaine.
• Majority of patients experienced moderate-to-severe pain during incision and drainage.
• No significant pain reduction observed with buffered lidocaine for the procedure.

Conclusions:

• Sodium bicarbonate buffering of 2% lidocaine with epinephrine did not significantly decrease pain.
• The study did not find a benefit for buffered lidocaine in this patient population and procedure.
• Further research may be needed to explore pain reduction strategies for dental abscess drainage.