• Oluwatola Afolabi, Amanda Murphy, Bryan Chung, and Donald H Lalonde.
• Division of Plastic Surgery, Dalhousie University, Halifax, Nova Scotia.
• Can J Plast Surg. 2013 Jan 1; 21 (4): 209-12.

BackgroundThe acidity of lidocaine preparations is believed to contribute to the pain of local anesthetic injection.ObjectiveTo investigate the effect of buffering lidocaine on the pain of injection and duration of anesthetic effect.MethodsA double-blind, randomized trial involving 44 healthy volunteers was conducted. The upper lip was injected with a solution of: lidocaine 1% (Xylocaine, AstraZeneca, Canada, Inc) with epinephrine; and lidocaine 1% with epinephrine and 8.4% sodium bicarbonate. Volunteers reported pain of injection and duration of anesthetic effect.ResultsTwenty-six participants found the unbuffered solution to be more painful. Fifteen participants found the buffered solution to be more painful; the difference was not statistically significant. Twenty-one volunteers reported duration of anesthetic effect. The buffered solution provided longer anesthetic effect than the unbuffered solution (P=0.004).ConclusionAlthough buffering increased the duration of lidocaine's anesthetic effect in this particular model, a decrease in the pain of the injection was not demonstrated, likely due to limitations of the study.

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