Double-Blind, Bilateral Pain Comparison with Simultaneous Injection of 2% Lidocaine versus Buffered 2% Lidocaine for Periocular Anesthesia

作者：Welch Mark N^*; Czyz Craig N; Kalwerisky Kevin; Holck David E E; Mihora Lisa D

来源：Ophthalmology, 2012, 119(10): 2048-2052.

DOI：10.1016/j.ophtha.2012.05.029

Purpose: Determine if raising the pH of 2% lidocaine with epinephrine 1: 100 000 to a physiologic level decreases pain perception during periocular, subcutaneous anesthesia. %26lt;br%26gt;Design: Double-blind, prospective, randomized study. Simultaneous unilateral injections of buffered and unbuffered lidocaine solutions were given before surgery to patients having bilateral, periocular surgery. %26lt;br%26gt;Participants: Fifty-four consecutive patients (27 male and 27 female; mean age, 68 years; standard deviation, 11 years). %26lt;br%26gt;Intervention: 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. %26lt;br%26gt;Main Outcome Measures: 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. %26lt;br%26gt;Results: 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. %26lt;br%26gt;Conclusions: 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.

• 出版日期2012-10