Comparison of Alkalinized and Plain Lignocaine on Injection Pain in Peribulbar Block-A Randomized Trial

Background: Pain during peribulbar anesthesia is commonly attributed to the acidic pH of local anesthetic solutions.Alkalinization increases the non-ionized fraction, improving tissue diffusion and reducing nociceptor sensitivity, thereby minimizing injection pain.Methods: In this prospective, randomized, double-blind trial, 80 patients scheduled for cataract surgery under peribulbar anesthesia were assigned into two groups.Group A received a standard anesthetic mixture, while Group B received the same mixture alkalinized with 7.5% sodium bicarbonate.Pain was assessed using a 10 cm visual analogue scale.Surgeon satisfaction and the need for supplemental anesthesia were also evaluated.Statistical analysis was performed using the Student's t-test, with significance at p<0.05.Results: The groups were comparable in terms of age and gender.The mean pain score in Group B (alkalinized lignocaine) was significantly lower at 1.15 (SD 1.3) compared to 2.05 (SD 1.8) in Group A (plain lignocaine) (p = 0.012).No significant differences were noted between groups regarding supplemental injections or surgeon satisfaction.Conclusion: Alkalinization of local anesthetic for peribulbar block significantly reduces injection pain without compromising anesthetic efficacy or surgeon satisfaction.Incorporating this technique can enhance patient comfort during cataract surgery.