Taking the 'ouch' out - effect of buffering commercial xylocaine on infiltration and procedure pain - a prospective, randomised, double-blind, controlled trial

Ann R Coll Surg Engl. 2004 May;86(3):213-7. doi: 10.1308/003588404323043382.


Aims: To compare the effect of buffered commercial 1% xylocaine (with 1:200,000 adrenaline) and the unbuffered commercial 1% xylocaine (with 1:200,000 adrenaline) preparation on pain during infiltration and procedure.

Patients and methods: A randomised, double blind controlled trial involving 85 patients who underwent bilateral vasectomy under local infiltration anaesthesia.

Results: Each patient served as his own control by receiving the buffered commercial preparation on one side and unbuffered commercial preparation on the other. Linear analogue pain scores during infiltration and procedure were recorded and analysed. The study demonstrated that pain perceived by the patient both during infiltration and the procedure was significantly lower when buffered commercial xylocaine was used as compared to the pain perceived with the use of unbuffered commercial xylocaine.

Conclusions: Use of buffered xylocaine is a simple, inexpensive and significantly effective way of reducing pain during infiltration and in surgical procedures performed under local anaesthesia.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anesthetics, Local / therapeutic use*
  • Buffers
  • Double-Blind Method
  • Epinephrine / therapeutic use*
  • Humans
  • Intraoperative Complications / prevention & control*
  • Lidocaine / therapeutic use*
  • Male
  • Middle Aged
  • Pain / prevention & control*
  • Pain Measurement
  • Prospective Studies
  • Vasectomy / adverse effects*
  • Vasectomy / methods


  • Anesthetics, Local
  • Buffers
  • Lidocaine
  • Epinephrine