Preparing storing beyond use dating of buffered lidocaine
We do not further manipulate any other final CSPs by adding or removing any solution, so this should also apply to the buffered lido, correct?
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Buffered lidocaine is widely used (lidocaine MDV and we add sodium bicarb).
In my mind, once we start manupulating the lidocaine vial by adding the sodium bicarb to it, it now becomes a CSP.
The drug acts on the nerve endings in the area of the body it is administered to, blocking the transmission of pain impulses to the brain.
Commonly, lidocaine is administered through an injection, and the injection itself can be painful for the patient receiving it.
Anecdotal reports suggest buffering lidocaine with epinephrine just before intraoral injection reduces time of onset, results in a deeper anesthetic effect, without the "sting" with injection from a low p H.
The higher p H of a buffered lidocaine injection may actually increase the rate at which the drug gets to the nerve endings, therefore speeding up the painkilling effect.
Another possible reason for the buffered drug to create less pain on injection is that the sodium bicarbonate ingredient actually produces its own painkilling effect.
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.
The way that this works is not yet known in detail as of 2011, but various explanations have been put forward.
Generally, they may act in conjunction with each other to produce this beneficial effect.