Elsevier

Annals of Emergency Medicine

Volume 19, Issue 12, December 1990, Pages 1387-1389
Annals of Emergency Medicine

Original contribution
Buffered versus plain lidocaine as a local anesthetic for simple laceration repair

https://doi.org/10.1016/S0196-0644(05)82603-4Get rights and content

Study objective:

Buffered lidocaine was compared with plain lidocaine as a local anesthetic for simple lacerations.

Design:

Randomized, double-blind, prospective clinical trial.

Setting:

Urban emergency department.

Type of participants:

Ninety-one adult patients with simple linear lacerations were enrolled. Patients with allergy to lidocaine and patients with an abnormal mental status were excluded.

Interventions:

Each wound edge was anesthetized with either plain or buffered lidocaine using a randomized, double-blind protocol. The pain of infiltration was measured with a previously validated visual analog pain scale.

Measurements and main results:

Analysis of pooled data and paired data (using patients as their own controls) revealed that infiltrating buffered lidocaine was significantly less painful than plain lidocaine (P = .03 and P = .02, respectively). There was no significant difference in the anesthetic effectiveness of the two agents during suturing.

Conclusion:

Buffered lidocaine is preferable to plain lidocaine as a local anesthetic agent for the repair of simple lacerations.

References (14)

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Cited by (99)

  • Laceration Management

    2017, Journal of Emergency Medicine
    Citation Excerpt :

    Lidocaine can be buffered by mixing 9 mL lidocaine with 1 mL of 8.4% sodium bicarbonate. Buffered lidocaine is significantly less painful on injection than regular lidocaine (56,57). Unfortunately, it is not commercially available, and must be compounded by hospital pharmacies.

  • Laceration repair

    2017, Urgent Care Medicine Secrets
  • Wound Management

    2012, Critical Care Nursing Clinics of North America
    Citation Excerpt :

    Although 30-gauge needles can be used for direct infiltration, 25- or 27-gauge needles are better suited for regional nerve blocks to decrease the possibility of deflection of the needle.18 Other available techniques to decrease pain of infiltration include buffering the anesthetic with sodium bicarbonate in a 1:10 solution, using warm solutions, using slow rates of infiltration, and pretreatment with topical anesthetic.19–21 Regional anesthesia blocks the nerve supply to the area of the laceration.

  • Management of Soft Tissue Injuries

    2012, Oral and Maxillofacial Trauma
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Presented at the Society for Academic Emergency Medicine Annual Meeting in Minneapolis, May 1990.

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