• R A Steinbrook, N Hughes, G Fanciullo, D Manzi, and F M Ferrante.
• Department of Anesthesia, Brigham and Women's Hospital, Boston, MA 02115.
• J Clin Anesth. 1993 Nov 1;5(6):456-8.

Study ObjectiveTo test the hypothesis that alkalinization of lidocaine decreases the pain of skin infiltration in surgical patients.DesignDouble-blind, randomized, prospective study.SettingPreoperative holding units, Brigham and Women's Hospital.Patients184 adult surgical patients.InterventionsWe compared the efficacy of 1% lidocaine with and without 0.1 mEq/ml of sodium bicarbonate (NaHCO3) for relief of pain of (1) skin infiltration and (2) intravenous (i.v.) catheterization prior to surgery.Measurements And Main ResultsPatients evaluated the intensity of pain using a 100 mm visual analog scale (VAS). There were no differences between study groups (lidocaine with NaHCO3, n = 89; lidocaine alone, n = 95) with respect to site of catheterization or catheter gauge used. Lidocaine plus NaHCO3 caused significantly less pain on skin infiltration (median VAS = 4; range = 0 to 51) than did lidocaine alone (VAS = 8; range = 0 to 48; p < 0.008). Pain of i.v. catheterization also did not differ between groups. There was a weak correlation between catheter gauge and pain of i.v. catheterization (r = -0.19; p = 0.01).ConclusionsPain resulting from skin infiltration of lidocaine solutions can be diminished by adding NaHCO3. However, catheter size is more important than the presence or absence of NaHCO3 in determining the pain of i.v. catheterization.

This article appears in the collection: Lignocaine.

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