Mixing sodium bicarbonate with lidocaine

Buffering local anesthetic for dental surgery

Michelle,

Did you ever get any information on buffering local anesthetic?

Thanks,

Craig

Professor

I am a Polish-American trauma/plastic surgeon in Warsaw.  I am currently back in the states for a short while, and I saw your question regarding buffering of lidocaine for oral procedures.

First, I have been buffering lidocaine in this manner since medical school, and I am still amazed at how many docs don't know about it!  Using either 1 or 2%, with or without Epi, I mix it approximately 50-50.  For oral trauma procedures, I use 2% Lidocaine.  I use the 8.4% solution of bicarb, but I suspect the 7.5% would work as well.  I use what they stock!

Why they don't prepackage in this buffered manner has to do with the degredation of the lidocaine molecule when it is in essence neutralized by the bicarb.  Although you can buffer it and use it immediately without any decrease in efficacy of the lidocaine, do not mix it and have a stock bottle of buffered lidocaine on hand. The lidocaine will be neutralized and you will get minimal, if any anesthesia.

Good luck.....Mike