A Comparative Study to Evaluate the Anesthetic Efficacy of Buffered Versus Non-buffered 2% Lidocaine During Inferior Alveolar Nerve Block

Tarang Kumar Jain; Rahul Jha; Anushree Tiwari; Neha Agrawal; Sheetal Mali; Anamika Sinha; Hiroj Bagde; Ramanpal Singh

doi:10.7759/cureus.31855

A Comparative Study to Evaluate the Anesthetic Efficacy of Buffered Versus Non-buffered 2% Lidocaine During Inferior Alveolar Nerve Block

Cureus. 2022 Nov 24;14(11):e31855. doi: 10.7759/cureus.31855. eCollection 2022 Nov.

Authors

Tarang Kumar Jain¹, Rahul Jha², Anushree Tiwari³, Neha Agrawal⁴, Sheetal Mali⁵, Anamika Sinha⁵, Hiroj Bagde⁶, Ramanpal Singh⁷

Affiliations

¹ Department of Oral and Maxillofacial Surgery, Rungta College of Dental Sciences & Research, Bhilai, IND.
² Department of Periodontology, Rungta College of Dental Sciences & Research, Bhilai, IND.
³ Department of Clinical Quality and Value, American Academy of Orthopaedic Surgeons, Rosemont, USA.
⁴ Department of Dentistry, Government Medical College, Mahasamund, IND.
⁵ Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND.
⁶ Department of Periodontology, Rama Dental College Hospital and Research Centre, Kanpur, IND.
⁷ Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Bilaspur, IND.

Abstract

Background: The study aimed to compare the clinical efficacy, safety, and acceptability of buffered lidocaine (8.4% sodium bicarbonate and 2% lidocaine with 1:80,000 adrenaline) versus non-buffered lidocaine (2% lidocaine with 1:80,000 adrenaline) during inferior alveolar nerve block.

Materials and methods: Fifty patients who required bilateral extractions in a single arch were included in this study. One hundred extractions were carried out, and all of the patients had nerve blocks during the procedure. We also took note of the patient's pain level as measured on a visual analog scale, as well as the start of the action, duration of postoperative analgesia, and occurrence of any problems. The duration of anesthesia was assessed by the feeling of numbness and the first sign of pain.

Result: All the patients in both study groups reported subjective numbness of the lips and tongue. The depth of anesthesia was evaluated by pain and comfort during the procedure with a visual analog scale and showed no significant difference between the two groups. The onset of action for the pterygomandibular nerve block was 1.240.31 minutes (buffered) and 1.710.51 minutes (non-buffered). When compared, the duration of anesthesia was 327.18102.98 minutes (buffered) and 129.0826.85 minutes (non-buffered).

Conclusion: This study concludes that the buffered solution has a faster onset of action than the non-buffered solution. Both solutions exhibit similar intraoperative efficacy. The duration of postoperative anesthesia was prolonged with buffering. Buffering also reduced pain scores during the early postoperative period.

Keywords: anesthesia; efficacy; lidocaine; nerve block; oral surgery.