EFFECT OF SODIUM BICARBONATE BUFFERED ARTICANE IN ACCELERATING THE ONSET OF ANAESTHESIA IN CHILDREN: A RANDOMISED CONTROLLED CLINICAL TRIAL

*Corresponding author INTRODUCTION Duration of the dental treatment is a very important factor for the success of the dental work especially in children, thus the demand for a less painful, faster onset and effective potency of anaesthetic solution is a great concern for pediatric dentists to maintain the cooperation of the children on dental chair. Buffered anaesthetic solutions create pH after injection nearly close to that of the normal tissue pH resulting in more rapid drug diffusion and a quicker onset of the nerve blocking as well as less painful experience during injection. Aim of the study to evaluate the effectiveness of adding 8.4%Sodium Bicarbonate to 4%Articane with ratio 1:19 in accelerating the onset time of the anaesthesia compared to using conventional unbuffered local anaesthesia. METHODOLOGY This study is a triple blinded randomized controlled clinical trial, cross-over design, that included 27 children, aged 5-7 with at least one lower molar in both sides indicated for pulpotomy. They were randomly allocated to two groups; (Test and control groups) according to the local anaesthetic solution where each patient randomly received buffered anaesthetic solution (BAS) in one side Figure (1) (Test group) and unbuffered anaesthetic solution (UBAS) on the other side (Control group). The onset time of the anaesthesia was recorded using Transcutaneous Electric Nerve Stimulator (TENS) on the lips of the child, where the lowest intensity at which the patient first reported feeling the stimulus was recorded before the administration of the anaesthesia then immediately after the injection the intensity was recorded every 30 seconds starting by the lowest intensity which was measured and increased gradually, until full lip numbness is declared Figure (2). RESULTS AND DISCUSSION A total of 27 children (16 males and 11 females) with mean age 6.5 participated in the study. The onset time showed a significant faster time in the BAS group (p<0.001), where the mean (SD) of BAS was 99.55(23.40) seconds while that of the UBAS was 137.33(23.89) seconds. The mean difference and SD between the two groups was 38.18(34.87) seconds. Figure (3)