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

Burns, Carrine A.; Ferris, Georgette; Feng, Changyong; Cooper, Jennifer Z.; Brown, Marc D.

doi:10.1016/j.jaad.2005.06.043

Cited by 74 publications

(58 citation statements)

References 16 publications

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“…However, Gershon et al 38 and Burns et al 39 found no significant pain reduc- À Teeth with failures were excluded from the onset of pulpal anesthesia. reported less pain with buffered lidocaine compared with unbuffered lidocaine in medical-surgical procedures.…”

Section: Discussionmentioning

confidence: 98%

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

Whitcomb¹,

Drum

Reader

et al. 2010

Anesthesia Progress

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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.

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Section: Discussionmentioning

confidence: 98%

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

Whitcomb¹,

Drum

Reader

et al. 2010

Anesthesia Progress

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“…Hal itu berdampak pada timbulnya rasa tidak nyaman sebelum tindakan pembedahan dilaksanakan. 6,7 Pada penelitian sebelumnya menunjukkan bahwa 68% pasien merasakan lebih nyeri saat infiltrasi anestesi lokal menggunakan lidokain HCl 1% apabila dibandingkan dengan lidokain 1% yang dialkalinisasi dengan menambahkan natrium bikarbonat 8,4% menggunakan rasio 1:10, sedangkan penelitian Nakayama dkk. 7 menunjukkan 88% pasien merasakan lebih nyeri saat infiltrasi anestesi lokal menggunakan lidokain HCl 1% dibandingkan dengan lidokain 1% yang ditambah dengan natrium bikarbonat 8,4% dengan perbandingan 1:10.…”

Section: 5unclassified

“…6,7 Penelitian ini bertujuan untuk mengetahui efek penambahan natrium bikarbonat 8,4% pada lidokain HCl 2% dengan perbandingan 1:10 dalam mengurangi nyeri saat infiltrasi.…”

Section: 5unclassified

“…Pada penelitian lain mempergunakan alkalinisasi lidokain HCl 2% dengan pengenceran 1:2 dan 1:5 untuk nyeri pada saat infiltrasi anestetik lokal tidak menunjukkan hasil yang signifikan untuk mengurangi nyeri saat infiltrasi anestetik lokal dibandingkan dengan tanpa alkalinisasi. 6,7,10 Data karakteristik umum subjek penelitian, baik pada kelompok eksperimen (LB) maupun kelompok kontrol (L) tidak berbeda baik jenis kelamin, usia, dan juga tingkat pendidikan, sehingga kedua kelompok dianggap homogen dan layak dibandingkan. Sebaran yang cukup merata pada jenis kelamin, usia, dan tingkat pendidikan pada kedua kelompok diharapkan dapat memperkecil bias yang mungkin timbul dalam persepsi nyeri pada pasien.…”

Section: Pembahasanunclassified

“…Hal ini mendukung penelitian sebelumnya, bahwa alkalinisasi lidokain HCl 2% mengurangi nyeri walaupun pada 2 penelitian sebelumnya tidak diketahui jumlah atau persentase pasien yang mengalami nyeri sedang sampai berat. 6,7 Alkalinisasi anestesi lokal akan mengurangi intensitas nyeri yang diakibatkan oleh infiltrasi anestetik lokal. Nyeri yang ditimbulkan akibat infiltrasi zat anestetik lokal disebabkan karena pH sediaan obat anestesia lokal bersifat asam, terutama sediaan yang mengandung epinefrin.…”

Section: Pembahasanunclassified

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Penambahan Natrium Bikarbonat 8,4% pada Lidokain 2% untuk Mengurangi Nyeri Saat Infiltrasi Anestetik Lokal

Rahmansyah¹,

Nawawi²,

Pradian³

2014

jap

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AbstrakInfiltrasi anestesi lokal di daerah penyuntikan jarum epidural menggunakan lidokain menimbulkan nyeri. Penelitian ini bertujuan untuk mengetahui keefektifan penambahan natrium bikarbonat 8,4% pada lidokain HCl 2% dengan perbandingan 1:10 untuk mengurangi nyeri saat infiltrasi. Penelitian dilakukan pada bulan Juni hingga Juli 2013 di Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung. Penelitian dilakukan dengan uji klinis acak tersamar ganda pada 44 pasien yang menjalani operasi dengan teknik anestesi epidural. Subjek dibagi 2 kelompok, kelompok eksperimen (LB) mendapatkan infiltrasi lidokain HCl 2% alkalin dengan menambahkan natrium bikarbonat 8,4% dengan perbandingan 1:10, kelompok kontrol (L) mendapatkan lidokain HCl 2%. Pada kedua kelompok dinilai numeric rating scale (NRS) saat infiltrasi lidokain HCl 2%. Hasil penelitian diuji dengan uji chi-kuadrat, uji-t, dan Uji Mann-Whitney, tingkat kepercayaan 95% dan kekuatan uji 94%, dianggap bermakna bila nilai p<0,05. Analisis statistik menunjukkan perbedaan bermakna nilai median NRS pada kelompok eksperimen dengan kelompok kontrol saat infiltrasi anestesi lokal (5 vs 3), dengan nilai rentang (3-6 vs 1-4) dengan nilai p<0,05. Simpulan penelitian ini adalah alkalinisasi lidokain HCl 2% dengan penambahan natrium bikarbonat 8,4% dengan perbandingan 1:10 mempunyai efek mengurangi nilai NRS.Kata kunci: Alkalinisasi, lidokain HCl 2%, natrium bikarbonat 8,4% Addition of 8.4% Sodium Bicarbonate to 2% Lidocaine in ReducingPain During Local Anaesthetic Infiltration AbstractLocal anesthetic infiltration in the area of epidural injections using lidocaine can cause pain. This research was done in June-July 2013, in Dr. Hasan Sadikin Hospital, to determine the effectiveness of adding 8.4% sodium bicarbonate to lidocaine HCl 2 % with 1:10 ratio. This was a double-blind randomized control study involving 44 patients undergoing surgery with epidural techniques. Subjects were divided into two groups, the experimental group (LB) was given 2% lidocaine HCl with sodium bicarbonate 8.4% 1:10 ratio as a local anestetich while the control group (L) was given lidocaine 2%. Numeric rating scale (NRS) was assessed during infiltration. Data was analyzed using chi-squere test, t-test and Mann-Whitney Test, with 95% confidence level and 94% strength tes and considered significant if p<0.05. Statistical anaylsis showed a significant difrerence in median of NRS in the experiment compared to control group during local anaesthetic infiltration (5 versus 3), with range of 3-6 versus 1-4 with p>0.05. In conclusion, alkalinization of 2% lidocaine HCl by addition of 8.4% sodium bicarbonate with 1:10 ratio has an effect in reducing NRS.

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Adjusting the pH of lidocaine for reducing pain on injection

Thackrey¹,

Arora²,

Cepeda³

et al. 2007

Cochrane Database of Systematic Reviews

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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

Cited by 74 publications

References 16 publications

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

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

Penambahan Natrium Bikarbonat 8,4% pada Lidokain 2% untuk Mengurangi Nyeri Saat Infiltrasi Anestetik Lokal

Adjusting the pH of lidocaine for reducing pain on injection

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