Effect of warming and buffering lidocaine on pain during facial anesthesia

Talu, Haluk; Elibol, Orhan; Yanyalı, Ateş; Karabaş, Levent; Alp, Banu; Çağlar, Yusuf

doi:10.1007/s12009-001-0072-3

Cited by 5 publications

(3 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…12 During neutralization, the continuously formed nonionized lidocaine (active form) can penetrate nerve cells and block the acid-sensing ion channel receptors from inside the synapse. 13,14 With NaCl 0.9% (pH 6.3), the buffering system of the body will also neutralize the solution. However, due to the absence of lidocaine, acidity will cause a noticeably longer duration of burning sensation until neutralization of the solution.…”

Section: Nacl 09% Is More Painful Than Unbuffered Lido/epimentioning

confidence: 99%

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

Vent

Surber

Johansen³

et al. 2020

Journal of the American Academy of Dermatology

View full text Add to dashboard Cite

Background: Neutralizing (buffering) lidocaine 1%/epinephrine 1:100,000 solution (Lido/Epi) with sodium hydrogen carbonate (NaHCO3) (also called sodium bicarbonate) is widely used to reduce burning sensations during infiltration of Lido/Epi. Optimal mixing ratios have not been systematically investigated. Objectives: To determine whether a Lido/Epi:NaHCO3 mixing ratio of 3:1 (investigational medicinal product 1) causes less pain during infiltration than a mixing ratio of 9:1 (IMP2) or unbuffered Lido/Epi (IMP3). Methods: Double-blind, randomized, placebo-controlled, crossover trial (n = 2 × 24) with 4 investigational medicinal products (IMP1-4). 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: Results of this trial cannot be generalized to other local anesthetics such as prilocaine, bupivacaine, or ropivacaine, which precipitate with NaHCO3 admixtures. 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.

show abstract

Section: Nacl 09% Is More Painful Than Unbuffered Lido/epimentioning

confidence: 99%

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

Vent

Surber

Johansen³

et al. 2020

Journal of the American Academy of Dermatology

View full text Add to dashboard Cite

show abstract

“…Local anesthetic agent application is an indispensable procedure in modern dentistry and medicine. At the same time local anesthetic injection is one of the most fearful and anxious procedure in medical and dental practice for both children and adults [1][2][3][4][5][6] . Local anesthetics can cause burning or stinging sensation during injection, and this sensation has been reported to keep people away from dental procedures.…”

Section: Introductionmentioning

confidence: 99%

“…Although warming of local anesthetic solution had been advocated by many authors to reduce pain during injection, some contrary reports with no benefits in reducing pain and accelerating onset of anesthesia 3,7 were published. In the medical literature, there are many studies investigating effectiveness of warming local anesthesia concerning ophthalmic, plastic and general surgery [3][4][5][6]7 . In contrast to medical literature, dental literature consists of fewer studies about possible benefits of warming local anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Effect of warming of local anesthesia on pain and anesthesia duration before wisdom tooth extraction

Ulu

Etöz²,

Demirbaş³

et al. 2019

Cukurova Medical Journal

View full text Add to dashboard Cite

Local anesthetic agents have been widely used in dentistry for several decades. Administration of local anesthetics at body temperature has been reported to shorten the onset time and reduce pain during injection. The aim of this study was to compare the effect of the local anesthetic at body temperature and room temperature before wisdom tooth extraction in terms of injection pain and onset of anesthesia. Materials and Methods: Forty-six adult patients, who were undergoing wisdom tooth extraction, participated in this split-mouth study. To the one side of the patient's jaws warmed anesthetic solution and to the other side anesthetic solution at room temperature was injected. Results: There was no statistically significant difference between two groups. Mean onset time of anesthesia and VAS scores during injection were similar for room temperature and warmed anesthetic solution groups. None of the patients exhibited any complications during and after injection. Conclusion: Further studies, which include large number of samples, may indicate the effectiveness of warmed anesthetic especially with regard to reducing pain during injection. Amaç: Lokal anestezik ajanlar uzun yıllardır diş hekimliğinde yaygın olarak kullanılmaktadır. Vücut sıcaklığında uygulanan lokal anesteziklerin anestezi süresini kısalttığı ve injeksiyon sırasında duyulan ağrıyı azalttığı rapor edilmiştir. Bu çalışmanın amacı yirmi yaş dişi çekimi öncesi uygulanan vücut sıcaklığında ve oda sıcaklığında lokal anesteziklerin ağrı ve anestezi süresi açısından etkilerinin karşılaştırılmasıdır. Gereç ve Yönem: Yirmi yaş dişi çekimi yapılacak 46 yetişkin hasta bu split-mouth çalışmaya dahil edildi. Hastaların çenelerinin bir tarafına ısıtılmış lokal anestezik enjekte edilirken diğer tarafına oda sıcaklığında local anestezik enjekte edildi. Bulgular: İki grup arasında istatistiksel olarak anlamlı fark bulunamadı. Ortalama anestezi süresi ve enjeksiyon sırasında elde edilen VAS değerleri her iki grupta da benzerdi. Enjeksiyon sırasında ve sonrasında hastalarda herhangi bir komplikasyon gözlenmedi. Sonuç: Daha fazla örnek içeren ileriki çalışmalar, özellikle enjeksiyon sırasında ağrıyı azaltma ile ilgili ısıtılmış anestezinin etkinliğini gösterebilir.

show abstract

Systematic Review and Meta-analysis of the Effect of Warming Local Anesthetics on Injection Pain

Hogan

vanderVaart

Perampaladas

et al. 2011

Annals of Emergency Medicine

View full text Add to dashboard Cite

Effect of warming and buffering lidocaine on pain during facial anesthesia

Cited by 5 publications

References 16 publications

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

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

Effect of warming of local anesthesia on pain and anesthesia duration before wisdom tooth extraction

Systematic Review and Meta-analysis of the Effect of Warming Local Anesthetics on Injection Pain

Contact Info

Product

Resources

About