Alkalinization of amide local anaesthetics by addition of 1% sodium bicarbonate solution

Eur J Anaesthesiol. 2000 Jan;17(1):38-42. doi: 10.1046/j.1365-2346.2000.00596.x.


A number of methods exist by which the pH of local anaesthetic solutions may be increased. Most commonly, these require the addition of differing amounts of sodium bicarbonate solution according to the local anaesthetic drugs. Sodium bicarbonate (1%) was titrated against pH in six commonly used local anaesthetic solutions. Titration curves of pH and volume of sodium bicarbonate solution added are shown for this group of local anaesthetics. This study demonstrates that 1 mL of 1% sodium bicarbonate solution may be used to alkalinize this range of local anaesthetics without the risk of precipitation. We also conclude that Ropivacaine (at concentration 0.75% and 1.0%), is unsuitable for alkalinization since it precipitates at a pH of 6.0.

MeSH terms

  • Alkalies / chemistry*
  • Amides / chemistry*
  • Anesthetics, Local / chemistry*
  • Bupivacaine / chemistry*
  • Chemical Precipitation
  • Epinephrine / chemistry
  • Humans
  • Hydrogen-Ion Concentration
  • Lidocaine / chemistry*
  • Ropivacaine
  • Safety
  • Sodium Bicarbonate / chemistry*
  • Temperature
  • Titrimetry


  • Alkalies
  • Amides
  • Anesthetics, Local
  • Ropivacaine
  • Sodium Bicarbonate
  • Lidocaine
  • Bupivacaine
  • Epinephrine