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Double-blind, bilateral pain comparison with simultaneous injection of 2% lidocaine versus buffered 2% lidocaine for periocular anesthesia
Ophthalmology, 08/20/2012
Clinical Article
Welch MN et al. – Buffering 2% lidocaine with epinephrine 1:100 000 with sodium bicarbonate 8.4% offers a clinically and statistically significant reduction in pain experienced by two–thirds of patients receiving periocular subcutaneous anesthesia.
Methods- Double–blind, prospective, randomized study.
- Simultaneous unilateral injections of buffered and unbuffered lidocaine solutions were given before surgery to patients having bilateral, periocular surgery.
- Fifty–four consecutive patients (27 male and 27 female; mean age, 68 years; standard deviation, 11 years).
- Patients were given simultaneous injections of buffered and unbuffered 2% lidocaine with epinephrine 1:100 000.
- The needles were inserted simultaneously and the anesthesia was injected for a 20–second count for a total volume of 1.0 ml per injected side.
- After the simultaneous injections, the patients were asked to rate the pain on each side on a Likert–type visual analog scale of 0 to 10.
- Sixty–five percent of patients preferred the buffered lidocaine with a scaled pain reduction of 0.9 (P = 0.0005).
- Additionally, for the patients who believed that the buffered solution was less painful, the mean decrease in scaled pain rating was 2, for a 51% reduction in pain level (P = 0.001).
- No gender differences were noted.