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pH adjustment schedule for the amide local anesthetics.
P T Ikuta1, S M Raza, Z Durrani
1Department of Anesthesiology, University of Illinois College of Medicine, Chicago.
Regional Anesthesia
|September 1, 1989
Summary
Adding sodium bicarbonate to local anesthetics improves nerve blockade but can cause precipitation. This study determined the maximum bicarbonate addition to amide local anesthetics to prevent precipitates for safer clinical use.
Area of Science:
- Anesthesiology
- Pharmaceutical Chemistry
Background:
- Alkalinizing local anesthetics with sodium bicarbonate enhances neural blockade.
- Excessive alkalinization can lead to precipitate formation, risking particulate injection.
Purpose of the Study:
- Determine the maximum sodium bicarbonate concentration for amide local anesthetics without precipitation.
- Develop a pH adjustment schedule for clinical alkalinization.
Main Methods:
- Titration of amide local anesthetics with sodium bicarbonate solutions.
- Visual inspection for precipitate formation at varying concentrations.
Main Results:
- Established specific maximal sodium bicarbonate limits for commonly used amide local anesthetics.
- Identified concentrations that induce precipitation.
Conclusions:
- Safe alkalinization protocols can be developed by understanding precipitate formation limits.
- A practical pH adjustment schedule will aid clinicians in optimizing local anesthetic delivery.