A Prospective, Randomized, Double-Blind Study of the Anesthetic Efficacy of Sodium Bicarbonate Buffered 2% Lidocaine With 1 : 100,000 Epinephrine in Inferior Alveolar Nerve Blocks

Abstract

The authors, using a crossover design, randomly administered, in a double-blind manner, inferior alveolar nerve ( IAN ) blocks using a buffered 2% lidocaine with 1 : 100,000 epinephrine/sodium bicarbonate formulation and an unbuffered 2% lidocaine with 1 : 100,000 epinephrine formulation at 2 separate appointments spaced at least 1 week apart. An electric pulp tester was used in 4-minute cycles for 60 minutes to test for anesthesia of the first and second molars, premolars, and lateral and central incisors. Anesthesia was considered successful when 2 consecutive 80 readings were obtained within 15 minutes, and the 80 reading was continuously sustained for 60 minutes. For the buffered 2% lidocaine with 1 : 100,000 epinephrine/sodium bicarbonate formulation, successful pulpal anesthesia ranged from 10^71%. For the unbuffered 2% lidocaine with 1 : 100,000 epinephrine formulation, successful pulpal anesthesia ranged from 10^72%. No significant differences between the 2 anesthetic formulations were noted. The buffered lidocaine formulation did not statistically result in faster onset of pulpal anesthesia or less pain during injection than did the unbuffered lidocaine formulation. We concluded that buffering a 2% lidocaine with 1 : 100,000 epinephrine with sodium bicarbonate, as was formulated in the current study, did not statistically increase anesthetic success, provide faster onset, or result in less pain of injection when compared with unbuffered 2% lidocaine with 1 : 100,000 epinephrine for an IAN block.

Effect of Sodium Bicarbonate–buffered Lidocaine on the Success of Inferior Alveolar Nerve Block for Teeth with Symptomatic Irreversible Pulpitis: A Prospective, Randomized Double-blind Study

“…Converting LA to the active cation through its effect on pH at the site of action inside the nerve Some studies have shown that buffering of LAs reduces the pain of injection (6,9,15,16), hastens the onset of anesthesia (6,9,16), and improves the success rate of anesthesia (9,17,18). Others have reported that buffering of LAs cannot reduce the pain of injection (19)(20)(21), hasten the onset of anesthesia (19,20), or improve the success rate of anesthesia (19,22).…”

A New and Enhanced Version of Local Anesthetics in Dentistry

“…Therefore, subjects in the buffered group received 17% less lidocaine. Although less lidocaine was administered to patients receiving the buffered formulation, the same success rate of anesthesia was achieved as with the unbuffered lidocaine formulation (18).…”

Mannitol an Adjuvant in Local Anaesthetic Solution: Recent Concept & Changing Trends (Review)

“…Michael Whitcomb et al, [23] concluded in a study that buffering a 2% lidocaine with 1:100,000 epinephrine with sodium bicarbonate, didn't statistically decrease the pain of injection, provide faster onset, or increase the profoundity of anesthesia when compared with unbuffered 2% lidocaine with 1:100000 epinephrine for an IAN block. The improved efficacy of local anesthetic solution with 0.5 mol/L.…”