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Reducing the discomfort of lidocaine administration through pH buffering
A H Matsumoto1, A C Reifsnyder, G D Hartwell
1Department of Radiology, University of Virginia Health Sciences Center, Charlottesville 22908.
Purpose:
A prospective, double-blind study was undertaken to evaluate the effect of using a buffered lidocaine solution on the perception of pain experienced by a patient during its intradermal injection.
Patients And Methods:
One hundred fifty patients undergoing diagnostic angiographic and interventional procedures at the authors' institution were randomly assigned to receive a 1-mL aliquot of one of three lidocaine solutions: plain 1% lidocaine, 1% lidocaine diluted with normal saline in a 10:1 ratio, and 1% lidocaine diluted with 8.4% sodium bicarbonate in a 10:1 ratio. The lidocaine solutions were administered intradermally over 10-15 seconds. A numerical value was placed on the patient's perception of pain, separate from that associated with the 25-gauge needle insertion, with use of a linear visual analog scale.
Results:
Mean pain scores were as follows: for the 1% lidocaine solution, 2.83 +/- 2.60; for 1% lidocaine plus normal saline solution, 2.89 +/- 2.34; and for 1% lidocaine plus sodium bicarbonate solution, 1.37 +/- 1.73 (P = .0018).
Conclusion:
Buffering lidocaine significantly decreased the discomfort associated with its administration as a local anesthetic.