Decreasing the pain of local anesthesia: A prospective, double-blind comparison of buffered, premixed 1% lidocaine with epinephrine versus 1% lidocaine freshly mixed with epinephrine - 09/08/11
Rochester, New York
Abstract |
Background |
Local anesthetics are acidic and cause pain on infiltration into the skin. Two methods are commonly used by dermatologists to raise the pH of lidocaine with epinephrine: buffering with sodium bicarbonate or freshly mixing lidocaine with epinephrine on the day of use.
Objective |
Our purpose was to compare the pain induced by infiltration of the skin with 1% lidocaine with epinephrine 1:100,000 buffered with sodium bicarbonate (buffered) versus 1% lidocaine freshly mixed with epinephrine (fresh).
Methods |
Sixty volunteers were recruited for this prospective, double-blind study. Each subject received an intradermal injection of the buffered solution and the fresh solution. Immediately after each injection subjects rated the pain of infiltration on a 100-mm visual analog scale. The pain scores for the anesthetic solutions were compared using the paired t test.
Results |
The pain score for the buffered solution was 18.3 ± 20.3, and the pain score for the fresh solution was 23.5 ± 19.1 (P = .0543). Sixty-five percent of subjects felt the fresh solution was more painful than the buffered solution.
Limitations |
The results did not reach statistical significance.
Conclusion |
In this small study, buffered lidocaine with epinephine caused less pain on infiltration into the skin than lidocaine freshly mixed with epinephrine, but the results were not statistically significant.
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Funding sources: None. Conflicts of interest: None identified. |
Vol 54 - N° 1
P. 128-131 - janvier 2006 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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