A randomized controlled trial of buffered lidocaine for local anesthetic infiltration in children and adults with simple lacerations.

This study assessed the efficacy of buffered lidocaine in children and adults for the repair of simple lacerations. We compared plain lidocaine (PL) with buffered lidocaine (BL) in a prospective, randomized, double-blind, placebo controlled trial. Children had a 10-point pain score assessed by a nurse using predetermined behavior criteria, and a visual analog pain score (VAS) as perceived by the parent. Adult visual analog scores were self reported. In 135 adults, the median VAS was 2.1 for PL and 2.0 for BL. In 136 children, the median nurse-rated pain score was 4.5 for both PL and BL. The parent's median VAS was 4.5 for PL and 4.0 for BL. In contrast to previous studies, we conclude that buffered lidocaine does not reduce infiltration pain in children or adults.

[1]  P. Mushlin,et al.  Sodium bicarbonate attenuates pain on skin infiltration with lidocaine, with or without epinephrine. , 1987, Anesthesia and analgesia.

[2]  Ronald Melzack,et al.  Handbook of pain assessment , 1992 .

[3]  D. Wong,et al.  Pain in children: comparison of assessment scales. , 1988, The Oklahoma nurse.

[4]  J. Ducharme Proceedings from the first international symposium on pain research in emergency medicine: Foreword. , 1996, Annals of emergency medicine.

[5]  M Orlinsky,et al.  Pain comparison of unbuffered versus buffered lidocaine in local wound infiltration. , 1992, The Journal of emergency medicine.

[6]  J. Spence,et al.  Review of pain-measurement tools. , 1996, Annals of emergency medicine.

[7]  J. Robertson Pediatric pain assessment: validation of a multidimensional tool. , 1993, Pediatric nursing.

[8]  R. F. Walsh Pain in infants, children, and adolescents, Schechter NL, Berde CB, Yaster M (Eds.). Williams & Wilkins, Baltimore, Maryland (1993) , 1993 .

[9]  T. Terndrup,et al.  Nasal versus oral midazolam for sedation of anxious children undergoing laceration repair. , 1994, Annals of emergency medicine.

[10]  A. Lloyd-Thomas,et al.  Pain management in children. , 1991, British medical bulletin.

[11]  K. Todd,et al.  Clinical versus statistical significance in the assessment of pain relief. , 1996, Annals of emergency medicine.

[12]  P. Paris,et al.  Pain Management in Emergency Medicine , 1987 .

[13]  K. Todd,et al.  The minimum clinically important difference in physician-assigned visual analog pain scores. , 1996, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[14]  R. A. Christoph,et al.  Pain reduction in local anesthetic administration through pH buffering. , 1988, Annals of emergency medicine.

[15]  E. Gracely,et al.  Pain of local anesthetics: rate of administration and buffering. , 1998, Annals of emergency medicine.

[16]  J.Stephen Huff Clinical procedures in emergency medicine , 1985 .

[17]  J. Ducharme Emergency pain management: a Canadian Association of Emergency Physicians (CAEP) consensus document. , 1994, The Journal of emergency medicine.

[18]  E. C. Huskisson,et al.  Graphic representation of pain , 1976, Pain.

[19]  H. Thode,et al.  Comparison of plain, warmed, and buffered lidocaine for anesthesia of traumatic wounds. , 1995, Annals of emergency medicine.

[20]  T. Terndrup,et al.  Pediatric pain control. , 1996, Annals of emergency medicine.

[21]  T. Nick,et al.  Comparison trial of four injectable anesthetics for laceration repair. , 1996, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[22]  E. Gallagher,et al.  Buffered versus plain lidocaine as a local anesthetic for simple laceration repair. , 1990, Annals of emergency medicine.

[23]  J. D’Astous,et al.  Oral Morphine Versus Injected Meperidine (Demerol) for Pain Relief in Children After Orthopedic Surgery , 1987, Journal of pediatric orthopedics.

[24]  R. Cantor,et al.  Pediatric analgesia and sedation. , 1994, Annals of emergency medicine.

[25]  M. Yaster,et al.  Pain in Infants, Children, and Adolescents , 1993 .

[26]  I. Jacobs,et al.  A randomized, controlled trial of oral midazolam and buffered lidocaine for suturing lacerations in children (the SLIC Trial). , 1995, Annals of emergency medicine.