Notes On Physiology And Pathophysiology

929 Words Apr 3rd, 2015 4 Pages
Student No: 15077002

168.733
Physiology and pathophysiology
Assignment Two

Alkalinisation of local anaesthetics to reduce pain on infiltration

Name: Antony Kocheril
Area of Practice: Day Surgery Unit
Work place: Waitakere Hospital

Local anaesthetics are usually acidic solutions (pH between 3.5 and 7.0), and this is one of the common causes of pain associated with local infiltration anaesthesia (1-4). This pain, often described as a burning sensation, can be severe enough for patients to decline surgery (5-6). Although increasing the pH by adding bicarbonate to local anaesthetics may reduce pain, the extent of this analgesic effect is uncertain (3). The purpose of this study is to analyse the efficacy of this practice in the day surgery unit.
Alkalinisation of the amide group of local anaesthetic solutions with sodium bicarbonate have shown benefit in several double blind randomised controlled trials (7-11). Research from UK agreed that administration of lidocaine (1%), one of the commonly used local anaesthetics buffered with sodium bicarbonate (1mEq/ml) significantly decreased the pain than the unbufferd solutions containing epinephrine (P = 0.001) (9). A similar trend was noted in another study conducted in California, in which sixty five percent of patient’s…
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