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Buffered lidocaine for skin infiltration prior to hemodialysis

A J Richtsmeier1, J W Hatcher

  • 1Rush Medical College, Chicago, IL 60612, USA.

Journal of Pain and Symptom Management
|April 1, 1995
PubMed

Insights

Buffering lidocaine (BL) with sodium bicarbonate did not significantly reduce pain during arterial and venous cannulation for pediatric hemodialysis. Injection speed, however, appeared to influence pain perception in children undergoing these procedures.

Area of Science:

  • Anesthesiology
  • Pediatric Nephrology

Background:

  • Local anesthesia is crucial for procedures like hemodialysis cannulation in children.
  • Lidocaine is commonly used, but its buffering status may affect pain perception.

Purpose of the Study:

  • To compare the efficacy of buffered versus unbuffered lidocaine in reducing pain during cannulation for pediatric hemodialysis.
  • To evaluate patient-reported and observed pain levels associated with different lidocaine preparations.

Main Methods:

  • A randomized, blinded study involving seven pediatric hemodialysis patients (ages 6-18).
  • Compared 1% lidocaine (L) with buffered lidocaine (BL) prepared by adding sodium bicarbonate.
  • Assessed pain via self-report and behavioral observations during 101 dialysis treatments.

Main Results:

  • No significant differences in self-reported or observed pain were found between buffered and unbuffered lidocaine during infiltration or cannulation.
  • Injection speed, which was not controlled, emerged as a potential factor influencing pain.

Conclusions:

  • Buffering lidocaine with sodium bicarbonate did not demonstrate a significant advantage in reducing cannulation pain for pediatric hemodialysis.
  • Further research into technique variables, such as injection speed, is warranted to optimize pain management in this population.

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