Randomised control trial of pH buffered lignocaine with adrenaline in outpatient operations

Br J Plast Surg. 1998 Jul;51(5):385-7. doi: 10.1054/bjps.1997.0293.


Bicarbonate buffering of local anaesthetics is known to significantly decrease the pain of their administration and yet few practising surgeons do so. A double-blind randomised cross-over clinical trial was conducted to confirm the practicality and efficacy of bicarbonate buffering of lignocaine with adrenaline in the setting of a busy local anaesthetic operating theatre. 40 patients received either buffered or control local anaesthetic solutions in equivalent sites on opposite sides of the body. The pain of each injection was rated from 0 (no pain) to 10 (extreme pain). The mean pain score for the buffered solution was significantly lower than the control solution (3.06 vs 4.34, P = 0.002). Bicarbonate buffering of lignocaine with adrenaline is effective, inexpensive and simple; its widespread use should be encouraged.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adrenergic Agonists
  • Ambulatory Surgical Procedures*
  • Anesthetics, Local / adverse effects*
  • Anesthetics, Local / chemistry
  • Buffers
  • Cross-Over Studies
  • Double-Blind Method
  • Epinephrine
  • Humans
  • Hydrogen-Ion Concentration
  • Injections, Subcutaneous / adverse effects
  • Lidocaine / adverse effects*
  • Lidocaine / chemistry
  • Pain / etiology
  • Pain / prevention & control*
  • Sodium Bicarbonate


  • Adrenergic Agonists
  • Anesthetics, Local
  • Buffers
  • Sodium Bicarbonate
  • Lidocaine
  • Epinephrine