Buffered lidocaine 1%/epinephrine 1:100,000 with sodium bicarbonate (sodium hydrogen carbonate) in a 3:1 ratio is less painful than a 9:1 ratio: A double-blind, randomized, placebo-controlled, crossover trial.
Adult
Anesthesia, Local
/ adverse effects
Anesthetics, Local
/ administration & dosage
Buffers
Cross-Over Studies
Double-Blind Method
Epinephrine
/ administration & dosage
Female
Humans
Lidocaine
/ administration & dosage
Male
Middle Aged
Pain, Procedural
/ etiology
Sodium Bicarbonate
/ administration & dosage
Vasoconstrictor Agents
/ administration & dosage
Young Adult
3:1
admixture
bicarbonate
burning sensation
controlled
double-blind
epinephrine
lidocaine
local anesthesia
placebo
randomized
ratio
sodium hydrogen carbonate
trial
unbuffered
Journal
Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
12
12
2018
revised:
01
09
2019
accepted:
12
09
2019
pubmed:
21
1
2020
medline:
22
1
2021
entrez:
21
1
2020
Statut:
ppublish
Résumé
Neutralizing (buffering) lidocaine 1%/epinephrine 1:100,000 solution (Lido/Epi) with sodium hydrogen carbonate (NaHCO To determine whether a Lido/Epi:NaHCO Double-blind, randomized, placebo-controlled, crossover trial (n = 2 × 24) with 4 investigational medicinal products (IMP1-4). The 3:1 mixing ratio was significantly less painful than the 9:1 ratio (P = .044). Unbuffered Lido/Epi was more painful than the buffered Lido/Epi (P = .001 vs IMP1; P = .033 vs IMP2). IMP4 (NaCl 0.9% [placebo]) was more painful than any of the anesthetic solutions (P = .001 vs IMP1; P = .001 vs IMP2; P = .016 vs IMP3). In all cases, the anesthesia was effective for at least 3 hours. Results of this trial cannot be generalized to other local anesthetics such as prilocaine, bupivacaine, or ropivacaine, which precipitate with NaHCO Lido/Epi-NaHCO
Sections du résumé
BACKGROUND
BACKGROUND
Neutralizing (buffering) lidocaine 1%/epinephrine 1:100,000 solution (Lido/Epi) with sodium hydrogen carbonate (NaHCO
OBJECTIVES
OBJECTIVE
To determine whether a Lido/Epi:NaHCO
METHODS
METHODS
Double-blind, randomized, placebo-controlled, crossover trial (n = 2 × 24) with 4 investigational medicinal products (IMP1-4).
RESULTS
RESULTS
The 3:1 mixing ratio was significantly less painful than the 9:1 ratio (P = .044). Unbuffered Lido/Epi was more painful than the buffered Lido/Epi (P = .001 vs IMP1; P = .033 vs IMP2). IMP4 (NaCl 0.9% [placebo]) was more painful than any of the anesthetic solutions (P = .001 vs IMP1; P = .001 vs IMP2; P = .016 vs IMP3). In all cases, the anesthesia was effective for at least 3 hours.
LIMITATIONS
CONCLUSIONS
Results of this trial cannot be generalized to other local anesthetics such as prilocaine, bupivacaine, or ropivacaine, which precipitate with NaHCO
CONCLUSIONS
CONCLUSIONS
Lido/Epi-NaHCO
Identifiants
pubmed: 31958526
pii: S0190-9622(20)30066-9
doi: 10.1016/j.jaad.2019.09.088
pii:
doi:
Substances chimiques
Anesthetics, Local
0
Buffers
0
Vasoconstrictor Agents
0
Sodium Bicarbonate
8MDF5V39QO
Lidocaine
98PI200987
Epinephrine
YKH834O4BH
Types de publication
Comparative Study
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
159-165Commentaires et corrections
Type : CommentIn
Type : CommentIn
Type : CommentIn
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.