• Journal of Yeungnam Medical Science
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• v.11 no.1
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• pp.30-34
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• 1994

Local anesthetics produce pain during infiltration into skin. The relationship between local anesthetic-induced pain and pH of the local anesthetic solution has not been fully investigated. Commercial preparation of local anesthetics are prepared as acidic solutions of the salts to promote solubility and stability. And the acidity of local anesthetic solition may be related with the pain during infiltration of the solutione. So, we tried to neutralize the lidocaine hydrochloride solution which is one of the most frequently used local anesthetic agent. Sodium bicarbonate was used for neutralization. Sodium bicarbonate was mixed with lidocaine hydrochloride until the resulting pH of the solution become 7.4 which is identical to the acidity of body fluid. To identify the effect of neutralized lidocaine solution, we had a course of double blind test to 6 volunteers. Both forearm of each volunteer were injected with neutralized lidocaine and plain one, and the degree of pain was estimated by each volunteers. According to subjective description by the volinteers, everyone felt neutralized lidocaine injection site was less painful than plain lidocaine. We concluded that we could reduce pain from infiltration of lidocaine hydrochloride by neutralization of the anesthetic solution with sodium bicarbonate.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.3
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• pp.276-282
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• 2005

Inferior alveolar nerve block using lidocaine is the most frequent local anesthetic method in the dental treatment, but clinically it is not always successful. The 2% lidocaine cartridge has been used commonly in dental anesthesia. It contains vasoconstrictor and antioxidant, which presents low pH which provides chemical stability and longer shelf life. But alkalinized local anesthetics has less tissue trauma, easier dissociation of the non-ionized base which penetrates nerve sheath, rapid onset and more intensity. In this study, in inferior alveolar nerve block, alkalinized lidocaine using sodium bicarbonate (experimental group) is compared with plain lidocaine (control group) about injection pain, anesthetic onset, duration and postinjection discomfort. In inferior alveolar nerve block, alkalinized lidocaine using sodium bicarbonate showed lower injection pain. There was significant difference statistically from plain lidocaine(p=0.019). Comparing with plain lidocaine, alkalinized lidocaine produced more rapid onset (lip & pulp anesthetic onset), there was no significant difference(p>0.05). but there was boundary significance (0.050.05). These results suggest that addition of sodium bicarbonate to 2% lidocaine(1:100,000 epinephrine) for inferior alveolar nerve block is more effective for reduction of injection pain and onset time.

• Ocean and Polar Research
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• v.26 no.3
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• pp.475-480
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• 2004

Recently, less toxic and more effective anaesthetics are essential for marine fishes. Lidocaine belongs to a group of anaesthetics which are used as local anaesthetic in human medicine. This chemical was tested fer winter flounder, Pleunnectes americanus. Anaesthetic effect of lidocaine hydrochloride-sodium bicarbonate mixture (lidocaine $HCl/NaHCO_3$) was tested for the winter flounder at five different temperature regimes: $3^{\circ}C,\;7^{\circ}C,\;11^{\circ}C,\;15^{\circ}C\;and\;19^{\circ}C$ Anaesthetic dose and temperature-dependent relationship in exposure and recovery time were observed for the winter flounder of $17.2{\pm}0.1cm$ mean total length. Based on the results, anaesthetic lidocaine $HCl/NaHCO_3$ showed rapid exposure time and rapid recovery time for winter flounder. The results indicate that lidocaine $HCl/NaHCO_3$ can be used as suitable anaesthetic for this species.

• Journal of Korean Academy of Nursing
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• v.39 no.2
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• pp.270-278
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• 2009

Purpose: This study was performed to find out the effects of lidocaine or 8.4% sodium bicarbonate mixed with rocuronium on mean arterial pressure, heart rate and withdrawal movement. Methods: Data collection was performed from December 15, 2006 through May 31, 2007. Seventy-five patients with American Society Anesthesiologist (ASA) physical status I & II, under general anesthesia, were randomly assigned to 1 of 3 groups: R group (RG) received rocuronium 0.6 mg/kg; RL group (RLG), rocuronium 0.6 mg/kg mixed with 2 mL of 2% lidocaine; RS group (RSG), rocuronium 0.6 mg/kg with the same volume of 8.4% sodium bicarbonate. Mean arterial pressure, heart rate and withdrawal movement were observed from its injection until 5 min after endotracheal intubation. Results: The incidence of withdrawal movement with its corresponding injections was 72%, 40% and 4% in RG, RLG and RSG, respectively (p<.001). Score of withdrawal movement was the lowest in RSG of all groups (p<.001). While mean arterial pressure (p=.011) in RSG decreased significantly, and heart rate (p=.003) in RG increased more with its injection than before induction of anesthesia. Conclusion: Administration of the equivalent volume of 8.4% sodium bicarbonate with rocuronium is more effective than that of lidocaine with rocuronium compared with rocuronium only, in preventing withdrawal movement and in stabilizing mean arterial pressure and heart rate.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.36 no.5
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• pp.449-453
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• 2003

Anaesthetic effect of lidocaine hydrochloride-sodium bicarbonate mixture $(lidocaine\;HCL/NaHCO_3)$ and tricaine methanesulfonate (MS-222) was tested for the greenling (Hexagyammos otakii) at three different temperature regimes: $12^{\circ}C,\;8^{\circ}C\;and\;24^{\circ}C.$ Based on the exposure and recovery time, effective dose of lidocaine $HCl/NaHCO_3$ was 800 ppm $(18^{\circ}C)\;and\;300\;ppm\;(24^{\circ}C)$ for greenling of $21.0\pm1.4\;cm$ body length. Anaesthetic dose and temperature-dependent relationship in exposure and recovery time were observed. Effective dose of MS-222 at $18^{\circ}C$ was proven to be 125 ppm and 150 ppm. Combination of lidocaine $HCl/NaHCO_3$ and MS-222, considerably reduced the dosage of each anaesthetic required to give rapid, deep anaesthetic condition. In the dry exposure after anaesthetic, the control fish exhibition $22\%$ mortality after dry exposure of 20 min; whereas, the anaesthetic condition with 800 ppm lidocaine $HCl/NaHCO_3$ for 1 min exhibited delayed recoveries from the anaesthetic condition with mortalities of $20\%,\;41\%,\;78\%\;and\;100\%$ after dry exposures of 8 min, 12 min, 16 min and 20 min, respectively. The results indicate that lidocaine $HCl/NaHCO_3$ can be used as suitable anaesthetic for the greenling.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.3
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• pp.129-142
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• 2018

Introduction: This systematic review evaluated the use of buffered versus non-buffered lidocaine to increase the efficacy of inferior alveolar nerve block (IANB). Materials and Methods: Randomized, double-blinded studies from PubMed, Web of Science, Cochrane Library, Embase, and ProQuest were identified. Two of the authors assessed the studies for risk of bias. Outcomes included onset time, injection pain on a visual analog scale (VAS), percentage of painless injections, and anesthetic success rate of IANB. Results: The search strategy yielded 19 references. Eleven could be included in meta-analyses. Risk of bias was unclear in ten and high in one study. Buffered lidocaine showed 48 seconds faster onset time (95% confidence interval [CI], -42.06 to -54.40; P < 0.001) and 5.0 units lower (on a scale 0-100) VAS injection pain (95% CI, -9.13 to -0.77; P=0.02) than non-buffered. No significant difference was found on percentage of people with painless injection (P = 0.059), nor success rate (P = 0.290). Conclusion: Buffered lidocaine significantly decreased onset time and injection pain (VAS) compared with non-buffered lidocaine in IANB. However due to statistical heterogeneity and low sample size, quality of the evidence was low to moderate, additional studies with larger numbers of participants and low risk of bias are needed to confirm these results.

• Proceedings of the Korean Aquaculture Society Conference
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• 2006.05a
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• pp.300-301
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• 2006

• Journal of Aquaculture
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• v.11 no.1
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• pp.59-66
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• 1998

The effectiveness of lidocaine HCI (lidocaine HCI/sodium bicarbonate mixture) was tested as an anaesthetic for Rhynchocypris oxycephalus and R. steindachneri at three different temperatures of $10^{\circ}C.$, $15^{\circ}C.$ and $20^{\circ}C.$. Based on the exposure and recovery time, effective doses of lidocaine HCI were proven to be 300ppm ($20^{\circ}C.$), 400ppm ($15^{\circ}C.$), and 600ppm($10^{\circ}C.$) for R. oxcephaus, and 400ppm ($20^{\circ}C.$), 500ppm ($15^{\circ}C.$), and 600ppm ($10^{\circ}C.$) for R. steindachneri respectively. Anaesthetic dose and temperature-dependent relationship in exposure and recovery time were obseved for these two Rhynchocypris spops. There were size-related increases of exposure time on R. steindachneri in each dose of lidocaine HCI. However, dost-dependent increase of recovery time wea found in only the large size group of Rhynchocypris spp.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.1
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• pp.22-29
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• 2008

Purpose: The purpose of this study is to test the efficacy of various methods of fat harvesting in animal model by viability comparison with assay including cell counting, MTT assay, and histologic evaluation. Materials and methods: New Zealand white rabbits experiments were used. Groin fat pads were subjected to different harvest method varying ingredients of solution(Experiment 1: T1 solution= lidocaine 1000mg/L, epinephrine 1mg/L, sodium bicarbonate 10mgEq/L, Triamcinolone 10mgEq/L; T2 solution=lidocaine 1000mg/L, epinephrine 1mg/L, sodium bicarbonate 0mgEq/L, Triamcinolone 0mgEq/L) and pressure exerted on harvesting with Luer-Lock syringe connected to suction cannula.(Experiment 2: P1 group=3cc intermittent pressure; P2 group=10cc sustained pressure) Fat cell viability was assessed with cell counting with a hemocytometer, MTT assay, and histologic evaluation. Results: Experiment 1 Cell count: T1=2.4/3.4/4.2, T2=9.6/8.4/7.2($\times10^5$ per mL); MTT assay: T1=0.516/0.41/0.453/0.412/0.421, T2=0.925/0.765/0.54/0.634/0.614 in 21 days(absorbance); Histology: T1 showed elongated and, different in size and shape, and ruptured adipocytes with only a few normal adipocytes whereas T2 showed central core of fat with almost intact fat cells Experiment 2 Cell count: P1=1.2/3.2/4.2, P2=1.2/2.4/3.8($\times10^5$ per mL); MTT assay:P1=0.256/0.245/0.258/0.21/0.264, P2=0.12/0.231/0.245/0.313/0.281 in 21 days(absorbance); Histology: P1 showed somewhat evenly distributed normal-looking fat cells and P2 showed relatively irregular shape of fat cells with small blood vessel amongst adiopocytes. Conclusion: Viability was higher in ‘modified tumescent solution’without sodium bicarbonate and triamcinolone and we also found no significantly different viability between using intermittent pressure and using sustained pressure. But in terms of initial viability of fat cell, we can assume that lower intermittent pressure would make better clinical results.

• Journal of Chest Surgery
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• v.22 no.6
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• pp.1025-1035
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• 1989

Since we first performed open heart surgery on December 30, 1986, 126 cases were operated on up to August 31, 1989. Among the 126 cases, 65 cases were congenital heart disease of which 63 were acyanotic disease, and 61 cases were acquired heart disease, most of which were valvular heart disease. The age distribution of congenital heart disease was from 1 years 2 months to 48 years, and males had a slightly higher incidence. The age of acquired heart disease was from a minimum of 15 years to a maximum of 68 years, and the male to female ratio was 1;1.5. Midsternotomy was performed in all cases, and the aortic cannula was inserted through ascending aorta and the venous cannula inserted into the SVC and IVC through the right atrium. Vent was inserted through the right superior pulmonary vein. Cardioplegia solution was used in all cases; it was composed of sodium bicarbonate 3.5 ampule, KCL 14 mEq, 2% lidocaine 2.5 ml, 20 % albumin 50 ml and heparin 1000 units mixed to 950 ml with Hartman solution, and was made to 4oC and infused 10 ml per Kg every 20 minutes. The congenital heart disease had a variety of VSD in 32 cases, ASD 23 cases, PS 6 cases, PDA 2 cases, and one case each of Ebsteins anomaly and tricuspid atresia. The operations performed for acquired heart disease were 4 cases of OMC, 33 cases of MVR, and 5 cases of AVR, and 1 case of AVR with CABG. DVR was perfomed in 13 cases, and triple valve replacement was done in 1 case. Other than these, excision of LA myxoma was 2 cases, and repair of traumatic VSD and removal of a pulmonary embolism were one case each. The surgical mortality was 5 cases[4%], all of which occurred in valve replacement cases. Follow-up study revealed 2 late deaths. One died after a traffic accident and one died due to sepsis after he had received a gastrectomy for ulcer bleeding. The remaining patients were in good condition.