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Syeda Mahnoor Fatima
Muhammad Ishaq
Ali Akhtar Khan
Raeha Nadeem
Zahra Saeed
Syeda Soveba Zaidi


alkalinization, adjusting pH, Buffering, local anesthetic, Pain, sodium bicarbonate visual analog scale (VAS)


Objective: To compare the efficacy of buffered local anesthetic with standard local anesthetic for insight into pain reduction and speed of onset of anesthesia in the presence of odontogenic infections for maxillary or mandibular infiltration.

Study Design: Double-blinded, Randomized clinical trial (Clinical trial number: IRCT202306220 58557N2).

Place and Duration of Study: Department of Armed Forces Institute of Dentistry, Rawalpindi, from March 2020 to September 2023.

Patients and Methods: A total of 100 (Group I-50, Group II-50) patients were included in the study who presented with odontogenic infection. All 100 patients received 2% lignocaine hydrochloride with adrenaline 1:100,000 and of these 100 patients,50 received a 1:10 dilution of the anesthetic cartridge with 0.18 ml solution of 8.4% sodium bicarbonate. The pain was accessed on a Visual analog scale before and after injection. The onset speed was measured by the time taken for the tissues injected to become numb after retrieval of the needle.

Results: According to the Visual Analog Scale score, the mean (SD) level of pain perceived after injection in Group I was 2.80 (0.83), and in Group II was 4.067 (1.65) which is statistically significant result (p=0.001). The mean (SD) time of onset of anesthesia in minutes was 1.32 (0.41) for the buffered group compared to 2.82 (0.45) for the non-buffered group respectively (p= <0.001).

Conclusion: The use of buffered anesthesia significantly reduced the pain and time for the onset of anesthesia compared to standard lignocaine cartridges, particularly in infected areas, thus increasing the effectiveness of local anesthetic injections.

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