buffered lidocaine + epinephrine

Buffered lidocaine with epinephrine is a local anesthetic formulation created by mixing standard 2% lidocaine (containing 1:100,000 epinephrine) with an alkalizing agent, typically 8.4% sodium bicarbonate, immediately prior to administration. This process, often facilitated by a mixing device such as the Onset pen, raises the pH of the anesthetic solution from its naturally acidic state (pH ~3.5–4.5) to a more physiological level (approximately pH 7.2–7.4). The primary clinical rationale for buffering is to reduce the injection pain (the "sting") associated with acidic solutions and to potentially accelerate the onset of anesthesia by increasing the concentration of the non-ionized, lipid-soluble form of the drug that can readily cross nerve membranes. University Hospitals Cleveland Medical Center has specifically investigated this formulation to evaluate its impact on physiological stress reactions in young children undergoing dental procedures under deep sedation. The active lidocaine component functions as a small molecule local anesthetic that blocks voltage-gated sodium channels, thereby inhibiting the initiation and conduction of pain signals.

Brand names

Onset

Other names

alkalinized lidocaine with epinephrinebuffered 2% lidocaine with 1:100,000 epinephrinebuffered local anesthetic