Increasing the pH of lidocaine solution decreases pain on injection and improves patient comfort and satisfaction

shutterstock_17571817- injection

This is a critical appraisal of a Cochrane review first published in December 2010.  The appraisal was prepared under the auspices of the American Dental Associations Centre for Evidence-based Dentistry

The objective of the Cochrane review was to determine if adjusting the pH of lidocaine had any effect on pain resulting from non-intravascular injections in adults and children.

The reviewer found this to be a well conducted review  but noted that the effect of alkalization on lidocaine on the quality of the sensory nerve block was not evaluated.

Overall the evidence suggests that increasing the pH of lidocaine solution with sodium bicarbonate decreases pain on injection and augments patient comfort and satisfaction.

In the section on implications for dental practice the reviewer noted the need for oral trials and further work because of the impact of buffering on the stability of anaesthetics.

Go to the ADA Summary

Cepeda MS, Tzortzopoulou A, Thackrey M, Hudcova J, Arora Gandhi P, Schumann R. Adjusting the pH of lidocaine for reducing pain on injection. Cochrane Database of Systematic Reviews 2010, Issue 12. Art. No.: CD006581. DOI: 10.1002/14651858.CD006581.pub2.



Share on Facebook Tweet this on Twitter Share on LinkedIn Share on Google+
Mark as read
Create a personal elf note about this blog
Profile photo of Derek Richards

Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

More posts - Website

Follow me here –