Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 30 196 2012 08 22 Effects of Buffering and Preparation Time of Topical Anesthetics on Pain of Injection into Oral Mucosa Effects of Buffering and Preparation Time of Topical Anesthetics on Pain of Injection into Oral Mucosa 13838 FA Nasser Kaviani Assistant Professor, Department of Oral and Maxillofacial Surgery AND Torabinejad Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran Mojtaba Rahimi Assistant Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0001-7725-9393 Sayed Morteza Heidari Associate Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Zahra Rahmani Dental Student, School of Dentistry And Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2011 10 29 Background: Many dental patients are afraid of injections. There are different methods for reducing pain during topical anesthetic injections. Some studies have reported buffering lidocaine to reduce injection pain. In this study, the effects of fresh and buffered topical anesthetic on injection pain were evaluated. Methods: In this prospective study, 4 groups of 20 dental treatment candidates were selected. Topical anesthetics for the 1st-4th groups included carpules of lidocaine/epinephrine, carpules of lidocaine/epinephrine/bicarbonate, freshly prepared lidocaine/epinephrine, and freshly prepared lidocaine/epinephrine/ bicarbonate, respectively. The initiation of topical anesthesia and injection pain were evaluated using a visual analogue scale (VAS). Findings: The highest and lowest mean scores of pain belonged to the carpule group (2.67 ± 0.28) and fresh lidocaine/epinephrine/bicarbonate (0.86 ± 0.37), respectively. While topical anesthesia started 2 minutes after injection in 95% of fresh lidocaine/epinephrine/bicarbonate group, the rate was as low as 50% in carpule group. Conclusion: Adding bicarbonate to carpules of lidocaine/epinephrine and fresh lidocaine/epinephrine is recommended to decrease injection pain and accelerate the onset of effect. Keywords: Bicarbonate, Dentistry, Local anesthesia, Pain Background: Many dental patients are afraid of injections. There are different methods for reducing pain during topical anesthetic injections. Some studies have reported buffering lidocaine to reduce injection pain. In this study, the effects of fresh and buffered topical anesthetic on injection pain were evaluated. Methods: In this prospective study, 4 groups of 20 dental treatment candidates were selected. Topical anesthetics for the 1st-4th groups included carpules of lidocaine/epinephrine, carpules of lidocaine/epinephrine/bicarbonate, freshly prepared lidocaine/epinephrine, and freshly prepared lidocaine/epinephrine/ bicarbonate, respectively. The initiation of topical anesthesia and injection pain were evaluated using a visual analogue scale (VAS). Findings: The highest and lowest mean scores of pain belonged to the carpule group (2.67 ± 0.28) and fresh lidocaine/epinephrine/bicarbonate (0.86 ± 0.37), respectively. While topical anesthesia started 2 minutes after injection in 95% of fresh lidocaine/epinephrine/bicarbonate group, the rate was as low as 50% in carpule group. Conclusion: Adding bicarbonate to carpules of lidocaine/epinephrine and fresh lidocaine/epinephrine is recommended to decrease injection pain and accelerate the onset of effect. Keywords: Bicarbonate, Dentistry, Local anesthesia, Pain https://jims.mui.ac.ir/article_13838_29f81692d9af87c8826aafca8ff5dad3.pdf