Combating inadequate anesthesia in periapical infections, with sodium bicarbonate: a clinical double blind study

Gupta, Savina; Mandlik, Geetanjali; Padhye, Mukul; Kini, Yogesh; Kakkar, Shruti; Hire, Abhinav Vijay

doi:10.1007/s10006-013-0418-1

Cited by 14 publications

(13 citation statements)

References 18 publications

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“…In this study, pain during injection was significantly lower in patients receiving buffered LA and this concurred with the results of previous studies that investigated the effect of buffered LA in dental extraction [7][8][9][10] Other studies, however, reported no differences in pain during injection between the patients who received buffered and non-buffered LA for maxillary teeth. 1,11 Also, Aulestia-Viera et al 4 in a systematic review and meta-analysis concluded that buffered lidocaine did not result in less pain during intraoral injections.…”

Section: Discussionsupporting

confidence: 91%

“…No complications associated with the use of buffered lidocaine were reported in this study which is in line with Gupta et al 8 . Kattan et al 2 in a systematic review and meta‐analysis reported that the incidence of adverse effects was a secondary outcome of the reviewed studies and that only one study reported the absence of adverse events, whereas the other studies made no mention of adverse events.…”

Section: Discussionsupporting

confidence: 89%

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Evaluation of buffered local anaesthesia in dental extraction: A randomized controlled study

Koja

Bede

2022

Oral Surgery

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Buffering of Local anaesthesia (LA) has been suggested as a mechanism to improve injection comfort and hasten the onset of anaesthesia. Aim This study aimed to evaluate the effectiveness of buffered LA in the extraction of maxillary premolars and molars. Materials and Methods This randomized controlled study included 100 patients who were indicated for extraction of maxillary posterior teeth, they were randomly divided into two groups; a study group that received infiltration of buffered 2% lidocaine hydrochloride with 1:80,000 epinephrine LA, and a control group that received non‐buffered 2% lidocaine hydrochloride with 1:80,000 epinephrine LA. The buffering was performed using the Onset® LA buffering system (Onpharma®). The outcome variables included the pain during injection buccally and palatally assessed by pain Numerical rating scale, the onset of anaesthesia, the volume of local anaesthesia used, and the patient satisfaction for the whole procedure. Results There were statistically significant differences in pain during injection buccally and palatally in favour of the study group (p < 0.0001) with a large effect size for the palatal injection and moderate effect size for the buccal injection. The onset of anaesthesia on the buccal and palatal sides was significantly faster in the study group (p values 0.02 and 0.01, respectively). There was a non‐significant difference between the groups with respect to the volume of anaesthesia (p = 0.07). The patients in the study group reported a significantly higher satisfaction score (p < 0.0001). Conclusions Buffered LA significantly reduced the onset of action of anaesthesia and pain during injection, especially on the palatal side, and resulted in better satisfaction with the extraction procedure.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 89%

Evaluation of buffered local anaesthesia in dental extraction: A randomized controlled study

Koja

Bede

2022

Oral Surgery

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“…However, we found no significant difference (Table 1). Previous studies by Al-Sultan et al (8,9), Kashyap et al (13), Gupta et al (14), and Malamed et al (15) have reported faster onset times with buffered formulations. Studies by Whitcomb et al (7) and Hobeich et al (16) have found buffering did not result in faster onset times.…”

Section: Discussionmentioning

confidence: 87%

“…They both concluded that buffering did not statistically improve anesthetic success. Regarding the onset of anesthesia, some authors (8,9,(13)(14)(15) have found a faster onset with buffered lidocaine formulations, whereas others have not (7,16). Systematic reviews in medicine have shown reduced injection pain with buffered anesthetics (17)(18)(19).…”

mentioning

confidence: 99%

Buffered 4% Articaine as a Primary Buccal Infiltration of the Mandibular First Molar: A Prospective, Randomized, Double-blind Study

Shurtz¹,

Nusstein

Reader

et al. 2015

Journal of Endodontics

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“…Alternatively, alkalinized LA solution can improve the anesthetic effect. 7 The local LA concentration is important in its onset and duration of action. The concurrent use of vasoconstrictors, such as epinephrine, reduces the rate of vascular absorption and prolongs the duration of action.…”

Section: Basic Pharmacologymentioning

confidence: 99%

Local Anesthesia in Interventional Radiology

Trerotola

2022

Semin intervent Radiol

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Interventional radiology is an evolving field that treats a variety of diseases. Local anesthetics is an important component of pain management during interventional radiologic procedures. It is highly effective and generally safe for routine procedures. However, local anesthetics can be associated with painful initial injection, allergic reactions, and rare but potentially devastating systemic toxicities. Recent evidence has shown that buffered solution and warm local anesthetics may reduce injection discomfort and improve clinical efficacy. Sensible safety practices and prompt recognition/treatment of the systemic toxicity are of paramount importance to provide safe local anesthesia. Interventional radiologists should be familiar with the basic pharmacology, common local anesthetics, optimizing strategies, complications, and management to provide safe and effective local anesthesia for patients.

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Combating inadequate anesthesia in periapical infections, with sodium bicarbonate: a clinical double blind study

Abstract: It has been observed in this study that the action of sodium bicarbonate in local anesthetics increases the pH levels of these solutions, thus possibly making them more effective in an acidic environment.

Cited by 14 publications

References 18 publications

Evaluation of buffered local anaesthesia in dental extraction: A randomized controlled study

Evaluation of buffered local anaesthesia in dental extraction: A randomized controlled study

Buffered 4% Articaine as a Primary Buccal Infiltration of the Mandibular First Molar: A Prospective, Randomized, Double-blind Study

Local Anesthesia in Interventional Radiology

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