title: A prospective, randomized, double-blind comparison of the injection pain and anesthetic onset of 2% lidocaine with 1:100,000 epinephrine buffered with 5% and 10% sodium bicarbonate in maxillary infiltrations.
abstract: BACKGROUND
  Local anesthetics can be buffered to a physiological pH before injection to decrease the time of onset and reduce injection pain.
  
  
  METHODS
  Thirty subjects with intact maxillary canines were included. The subjects randomly received, in a double-blind manner, 1 of the 3 maxillary infiltration injections of 1.8 mL 2% lidocaine with 1:100,000 epinephrine and 2% lidocaine with 1:100,000 epinephrine buffered at 5% and 10% with sodium bicarbonate by volume at 3 separate appointments. Pain on needle penetration and deposition of anesthetic solution was recorded by using a Heft-Parker visual analogue scale. Anesthetic onset was determined by 2 consecutive negative responses to electronic pulp test.
  
  
  RESULTS
  The mean anesthetic onset for nonbuffered anesthetics was 119 seconds, 116 seconds for the 5% buffered solutions, and 121 seconds for the 10% buffered solutions. There was no significant difference between the 3 groups. There was also no significant difference in pain on needle penetration or anesthetic deposition between the 3 anesthetic solutions tested.
  
  
  CONCLUSIONS
  Two percent lidocaine with 1:100,000 epinephrine buffered with 5% or 10% sodium bicarbonate did not differ from nonbuffered solutions in anesthetic onset or injection pain in maxillary infiltrations of canines with healthy pulps.
authors.affiliation: Department of Endodontics, Baylor College of Dentistry, Texas A&M University System Health Science Center, Dallas, Texas 75246, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Hobeich
authors.forename: Stephen
authors.initials: S
authors.lastname: Simon
authors.forename: Emit
authors.initials: E
authors.lastname: Schneiderman
authors.forename: Jianing
authors.initials: J
authors.lastname: He
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000737:chemistry; D002021:Buffers; D018592:Cross-Over Studies; D003481:Cuspid / Q000187:drug effects; D003782:Dental Pulp / Q000187:drug effects; D003791:Dental Pulp Test; D004311:Double-Blind Method; D004837:Epinephrine / Q000008:administration & dosage* / Q000737:chemistry; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007267:Injections / Q000009:adverse effects / Q000295:instrumentation; D008012:Lidocaine / Q000008:administration & dosage* / Q000737:chemistry; D008297:Male; D008437:Maxilla / Q000187:drug effects; D009339:Needles; D010147:Pain Measurement; D011446:Prospective Studies; D017693:Sodium Bicarbonate / Q000008:administration & dosage* / Q000737:chemistry; D013997:Time Factors; D014662:Vasoconstrictor Agents / Q000008:administration & dosage* / Q000737:chemistry; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D002021:Buffers; D014662:Vasoconstrictor Agents; D017693:Sodium Bicarbonate; D008012:Lidocaine; D004837:Epinephrine