“It will burn for a few seconds, then become numb…” Sound familiar? That’s how I describe the local infiltration of lidocaine to patients. In order to decrease the pain associated with the administration of lidocaine, our interventional radiology department has taught nephrologists to use lidocaine buffered with sodium bicarbonate (1 part NaHCO3 for 9 parts lidocaine) during local anesthesia in preparation for ultrasound guided kidney biopsies. A quick literature search reveals much support for this technique. One hypothesis is that the buffered solution has less protonated molecules which are lipophilic and can more readily enter the myelin sheath resulting in a more rapid onset of action. A second idea is that the buffered solution has less associated discomfort simply because it has a more physiologic pH.
On the other hand, one study showed that the administration rate of lidocaine may have more influence on the perceived pain associated with injection than does buffering. Slow, unbuffered injections were associated with less perceived pain than rapid, buffered injections. (http://www.annemergmed.com/article/S0196-0644(98)70278-1/abstract)
- ► 2021 (36)
- ► 2020 (32)
- ► 2019 (42)
- ► 2018 (57)
- ► 2017 (52)
- ► 2016 (45)
- ► 2015 (63)
- ► 2014 (95)
- ► 2013 (133)
- ► 2012 (201)
- ► 2011 (370)
- CLINICAL CASE 9
- The Online Transplant Center: Post transplant MPGN
- Post transplant MPGN
- TOPIC DISCUSSION: PCO2, which one is better?
- Image Quiz- Answers
- CONSULT ROUNDS: METHANOL and the EYE?
- CONSULT ROUNDS: ACID BASE
- JOURNAL CLUB: Kidney allograft nephrectomy can imp...
- TOPIC DISCUSSION: Nutrition
- TOPIC DISCUSSION: Drugs and Cyclosporine
- IN THE NEWS- NSF and Kidney Transplantation
- Bowel Transplantations, not enough!
- Horseshoe Kidney
- The Online Transplant Center: New Agents for renal...
- CLINICAL CASE 8
- History of Nephrology: The first randomised contro...
- Common Sense vs. Evidence-based Medicine
- TOPIC DISCUSSION: DIFFERENT TYPES OF PROTEINURIA
- New Agents for renal transplantation
- TOPIC DISCUSSION: Renal Artery Stenosis
- TOPIC DISCUSSION: THE WWW and the NEPHROLOGIST
- IN THE NEWS- Hyperkalemia treatment in trouble
- IN THE NEWS ---> ACUTE KIDNEY INJURY
- CONSULT ROUNDS: SIADH and Escitalopram ( lexapro)
- CONSULT ROUNDS: Clinical dilemma in Nephrogenic Di...
- CONSULT ROUNDS: Metformin toxicity, Lactic Acidosi...
- CLINICAL CASE 7
- IN THE NEWS- HgA1C for Diabetes Diagnosis. How abo...
- KIDNEY DONORS have Good Long term survival
- TOPIC DISCUSSION: VEGF Nephropathology
- TOPIC DISCUSSION: Post Transplant Collapsing FSGS,...
- Post Transplant Collapsing FSGS: Is it really all ...
- CLINICAL CASE 6
- Topic Discussion: OUCH!! Should Anesthesia Hurt??
- TOPIC DISCUSSION: Alcohol Poisonings, gaps and osm...
- Belatacept approved by FDA
- Protocol Biopsies in Renal Allograft Recipients
- ▼ March (37)