A Prospective, Randomized Double-Blinded Study to Evaluate the Efficacy of Buffered Local Anesthetics in Infected and Inflamed Pulp and Periapical Tissues.

Abstract

The aim of this study is to evaluate the efficacy of sodium bicarbonate as an additive alkalizing agent to local anesthetic solutions in inflamed and infected pulpal and periapical tissues. A prospective, randomized crossover double-blinded study was carried out in a university-affiliated hospital in Chennai. A randomized crossover double-blinded study was designed wherein ninety-six patients were enrolled for the study. 1.8ml of 2% lignocaine with 1:200,000 adrenaline was administered. The latency time period was found to be 5-10min and extraction was attempted. During extraction, if the patient experienced pain, 0.5ml of 8.4% sodium bicarbonate was injected into the previously injected local anesthesia site. A time period of 3min was allowed for the alkalinization to occur. Extraction was carried out only when the patient did not complain of pain. Pain score was assessed before and after administration of 8.4% sodium bicarbonate using visual analog scale. Pulse rate at the baseline, before and after administration of 8.4% sodium bicarbonate, was recorded and the pain scale values were correlated with pulse rate. It was found that there was a significant decrease in pain after injecting buffered local anesthetics (p < 0.1). Pain score before injecting sodium bicarbonate was higher when compared to post-injection of sodium bicarbonate. There was also significant reduction in pulse rate following the administration of sodium bicarbonate. Buffered 2% lignocaine with 1:200,000 epinephrine had early onset of anesthesia when compared to unbuffered form. Injecting 2% buffered lignocaine pain was significantly reduced during extraction in the teeth.