Journal of clinical and experimental dentistry · 2025
Evaluating Pain, Onset of Action, Duration, and Anesthetic Efficacy of Conventional and Buffered Lidocaine in Infiltration Anesthesia: A Comparative Clinical Study.
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Hamad Shehab A, Al-Dawoody Alah D, Alraad Ahmed Sh, Ahmed Osamah S
Аннотация
BACKGROUND: Buffered local anesthetics are proposed to alleviate injection pain, decrease onset time, and extend the duration of anesthesia. This research sought to evaluate the clinical effectiveness of buffered lidocaine compared to traditional lidocaine in patients having maxillary posterior teeth extraction due to chronic periapical lesions.
MATERIAL AND METHODS: This double-blind, prospective, randomized clinical trial involved 100 adult participants (ASA I or II), aged 18 to 60, who needed extraction of maxillary posterior teeth. Participants were randomly assigned into two equal groups: Group A was given standard 2% lidocaine with 1:100,000 adrenaline; Group B was administered buffered 2% lidocaine with 1:100,000 epinephrine combined with 8.4% sodium bicarbonate. Standardized supraperiosteal infiltrative anesthesia was given. Discomfort from the injection was assessed with the Visual Analogue Scale (VAS), and the onset and duration of anesthesia were noted as well. All surgeries were carried out by a surgeon who was unaware of the study, and results evaluated by a second investigator also blinded to the details.
RESULTS: Group B (buffered lidocaine) showed considerably reduced pain scores during injection (VAS 2.8 ± 0.7) in contrast to Group A (4.2 ± 0.9; p < 0.01). The initiation of anesthesia occurred notably quicker in Group B (2.3 minutes compared to 4.7 minutes; p < 0.01). The duration of anesthesia in Group B was notably greater (45.8 ± 7.6 minutes compared to 36.4 ± 8.2 minutes; p < 0.01). The requirement for reinjection was not notably different among the groups (p = 0.678).
CONCLUSIONS: Buffered lidocaine offers better anesthetic efficacy than standard lidocaine regarding injection comfort, quicker onset, and extended duration, making it a more effective choice for dental extractions.
MATERIAL AND METHODS: This double-blind, prospective, randomized clinical trial involved 100 adult participants (ASA I or II), aged 18 to 60, who needed extraction of maxillary posterior teeth. Participants were randomly assigned into two equal groups: Group A was given standard 2% lidocaine with 1:100,000 adrenaline; Group B was administered buffered 2% lidocaine with 1:100,000 epinephrine combined with 8.4% sodium bicarbonate. Standardized supraperiosteal infiltrative anesthesia was given. Discomfort from the injection was assessed with the Visual Analogue Scale (VAS), and the onset and duration of anesthesia were noted as well. All surgeries were carried out by a surgeon who was unaware of the study, and results evaluated by a second investigator also blinded to the details.
RESULTS: Group B (buffered lidocaine) showed considerably reduced pain scores during injection (VAS 2.8 ± 0.7) in contrast to Group A (4.2 ± 0.9; p < 0.01). The initiation of anesthesia occurred notably quicker in Group B (2.3 minutes compared to 4.7 minutes; p < 0.01). The duration of anesthesia in Group B was notably greater (45.8 ± 7.6 minutes compared to 36.4 ± 8.2 minutes; p < 0.01). The requirement for reinjection was not notably different among the groups (p = 0.678).
CONCLUSIONS: Buffered lidocaine offers better anesthetic efficacy than standard lidocaine regarding injection comfort, quicker onset, and extended duration, making it a more effective choice for dental extractions.