SGEM#307 - October 31, 2020 - By Admin
Reference: Vent et al. Buffered lidocaine 1%, epinephrine 1:100,000 with sodium bicarbonate (hydrogencarbonate) in a 3:1 ratio is less painful than a 9:1 ratio: A double-blind, randomized, placebo-controlled, crossover trial. JAAD (2020)
"CLINICAL QUESTION:
DOES BUFFERING LIDOCAINE WITH SODIUM BICARBONATE MAKE LOCAL ANESTHETIC LESS PAINFUL?
Authors’ Conclusions:
“Lido/Epi-NaHCO3 mixtures effectively reduce burning pain during infiltration. The 3:1 mixing ratio is significantly less painful than the 9:1 ratio. Reported findings are of high practical relevance given the extensive use of local anesthesia today.”
SGEM BOTTOM LINE:
CONSIDER BUFFERING YOUR LIDOCAINE WITH A 3:1 SODIUM BICARBONATE MIXTURE TO DECREASE THE DISCOMFORT OF LOCAL ANESTHETIC INFILTRATION.