1. Cepeda MS, Tzortzopoulou A, Thackrey M, Hudcova J, Arora Gandhi P, Schumann R. Adjusting the pH of lidocaine for reducing pain on injection. Cochrane database of systematic reviews (Online). 2010;12:CD006581.
All outcomes favour Buffering. Not a lot of children in studies but no reason to suspect it will not work in children to relieve infiltration pain.
Effect size seems clinically important and given the intervention is cheap and [relatively] easy, I would recommend.
When used with psychological intrerventions (and a few other tricks) it is very effective.
I have had many children now who report zero pain during injection of local and then the laceration repair.
On 16/11/2012, at 6:23 AM, Doc Holiday wrote:
> From: [log in to unmask]
>> With the current shortage of Sodium Bicarbonate 8.4%, how have you been mixing your 1% buffered lidocaine for use in wound infiltration, digital blocks, etc?
> --> We don't have a shorage of 8.4% Bicarb.
> We also don't use it to "buffer" lidocaine. Was not aware of evidence which shows it should be, but I have not looked for a number of years now - is there any?
> Regardless, I find that injecting very slowly initially and "going through already infiltrated areas" does the trick. If I want to be really "posh", then I use an ice cube first.
> No shortage of ice cubes, before anyone asks... ;-)
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Dr David Herd
Mater Children's Emergency
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