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Lidocaine HCl (C14H22N2O • HCl) has the following structural formula: Each single-dose vial contains Lidocaine Hydrochloride Injection, USP, which is a sterile nonpyrogenic aqueous solution intended for parenteral administration as a local anesthetic agent. Each m L contains 20 mg lidocaine hydrochloride and 6 mg sodium chloride, in Water for Injection.
Sodium hydroxide and/or hydrochloric acid may be used to adjust p H between 5.0 and 7.0.
Due to some recent changes in federal regulations, our major outsourcing supplier has rationed quantities of products we are able to purchase at this time as they work through FDA operational changes.
However, as referenced above, the stability of these products will be significantly shorter.
First, I have been buffering lidocaine in this manner since medical school, and I am still amazed at how many docs don't know about it!
Using either 1 or 2%, with or without Epi, I mix it approximately 50-50. I use the 8.4% solution of bicarb, but I suspect the 7.5% would work as well. Why they don't prepackage in this buffered manner has to do with the degredation of the lidocaine molecule when it is in essence neutralized by the bicarb.
We are an oral and maxillofacial surgeons office and would like to know the implications of mixing sodium bicarbonate with lidocaine to buffer the stinging sensation during injections.
The lidocaine will be neutralized and you will get minimal, if any anesthesia.
Mechanism of Action: Lidocaine stabilizes the neuronal membrane by inhibiting the ionic fluxes required for the initiation and conduction of impulses thereby effecting local anesthetic action.