The effect of pH-buffering on lignocaine's anesthetic properties during Inferior alveolar nerve block in children: A randomised controlled trial

Introduction: Pain management during local anesthesia administration is a critical aspect of pediatric dentistry, as procedures like Inferior alveolar nerve block (IANB) are often associated with significant discomfort. Buffered local anesthetics, which adjust the pH of the solution to a more physiological range, have been proposed as a method to reduce pain and accelerate the onset of anesthesia. Aim: This study aimed to evaluate the efficacy of pH-buffered lignocaine compared to standard lignocaine in terms of pain perception, onset time, and efficacy during dental procedures in children. Materials and Methods: A prospective randomized controlled trial was conducted with 30 children aged 6–10 years who required bilateral inferior alveolar nerve blocks. Participants were randomly assigned to receive either 2% lignocaine with epinephrine or buffered lignocaine prepared by mixing sodium bicarbonate with lignocaine in a 1:10 ratio. Pain perception was assessed using the Wong-Baker Faces Pain Scale and SEM scale, while onset and efficacy of anesthesia were evaluated through subjective (numbness) and objective (gingival probing) measures. Statistical analysis was performed using SPSS software. Results: Buffered lignocaine demonstrated significantly lower Wong-Baker pain scores (2.54 ± 1.35) compared to standard lignocaine (3.20 ± 1.05; p=0.007). The onset of anesthesia was faster with buffered lignocaine (60.00 ± 10.38 seconds) compared to standard lignocaine (73.63 ± 13.45 seconds; p=0.012). Efficacy measures also favoured buffered lignocaine, showing faster achievement of maximum anesthetic effect (75.00 ± 15.35 seconds vs. 85.63 ± 12.37 seconds; p=0.018). Conclusion: Buffered lignocaine is a more effective alternative to standard lignocaine for pediatric dental procedures, offering reduced pain and faster onset of anesthesia. Further studies are recommended to optimize preparation methods and storage conditions for buffered anesthetic solutions.