Effect of alkalinisation of lignocaine for intraoral nerve block on pain during injection, and speed of onset of anaesthesia

A Comparative Study Between Bupivacaine with Adrenaline and Carbonated Bupivacaine with Adrenaline for Surgical Removal of Impacted Mandibular Third Molar

“…This study confirms that alkalinisation of local anesthetic solution reduces pain on injection during deposition of local anesthetic solution and produces rapid onset of action of local anesthetic [28,29].…”

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

“…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).…”

Effect of Sodium Bicarbonate–buffered Lidocaine on the Success of Inferior Alveolar Nerve Block for Teeth with Symptomatic Irreversible Pulpitis: A Prospective, Randomized Double-blind Study

“…Concentrating LA inside the nerve trunk (diffusion trapping) 3. Converting LA to the active cation through its effect on pH at the site of action inside the nerve Some studies have shown that buffering of LAs reduces the pain of injection (6,9,15,16), hastens the onset of anesthesia (6,9,16), and improves the success rate of anesthesia (9,17,18). Others have reported that buffering of LAs cannot reduce the pain of injection (19)(20)(21), hasten the onset of anesthesia (19,20), or improve the success rate of anesthesia (19,22).…”