Use of a dorsal penile nerve block with lidocaine is believed to provide adequate pain relief, but many physicians do not use it, concerned that stinging from lidocaine at the injection site could add to the stress of the procedure.The time associated with administering the anesthetic may also be a factor.Commonly, lidocaine is administered through an injection, and the injection itself can be painful for the patient receiving it.
This is because it contains another ingredient that is more alkaline than lidocaine called sodium bicarbonate.
This chemical is the same substance that bakers add to bread as baking soda, and it is also found in some toothpastes.
No significant differences in heart rate, oxygen saturation, arousal score or general clinical observations were noted between groups.
Minor bleeding occurred in a small percentage of infants in each group; otherwise, there were no complications.
Once the solution gets into the body through an injection, it is thought that the acidic nature of the product irritates the tissue to produce the burning.
Buffered lidocaine has a more neutral p H than unbuffered lidocaine.
Carbon dioxide from the breakdown of the sodium bicarbonate could decrease the pain signals from the nerve ending, or instead help the lidocaine be more concentrated at the nerve ending.
Parents are increasingly asking for safe and effective pain relief for their infants during circumcision.
All healthy newborn boys circumcised at a large Midwestern hospital were eligible for the two-year study.
Infants were randomized to receive 1 percent lidocaine, either as a simple solution or buffered with sodium bicarbonate. The circumcisions were performed using standard technique, and involved personnel knew which anesthetic was used on each infant.
Buffered lidocaine has been shown to decease stinging and speed the anesthetic effect.