lidocaine + sodium bicarbonate + sodium chloride

This buffered local anesthetic solution was developed and studied by Boston Urogynecology Associates for pain management during intradetrusor onabotulinumtoxinA (Botox) injections in women with refractory overactive bladder. The solution is a specific mixture consisting of 50 mL of 1% lidocaine, 45 mL of 0.9% normal saline (sodium chloride), and 5 mL of 8.4% sodium bicarbonate. It is administered via intravesical instillation 20 minutes prior to the Botox injection procedure. The addition of sodium bicarbonate serves as a buffering agent to increase the pH of the lidocaine solution, which is intended to reduce the stinging sensation upon administration and potentially enhance the onset and efficacy of the local anesthetic by increasing the concentration of the non-ionized form of lidocaine. A prospective, double-blind, randomized controlled trial (NCT02441075) compared this protocol to a standard non-buffered lidocaine solution and found no significant difference in pain control between the two groups.

Other names

Buffered lidocaine solutionBuffered lidocaine protocol