The air-liquid interface and the pH and PCO2 of alkalinized local anaesthetic solutions. 1992

W E Ackerman, and T R Ware, and M Juneja
Department of Anesthesia, University of Cincinnati, College of Medicine, Ohio 45267-0531.

The alkalinization of certain local anaesthetics with sodium bicarbonate hastens the onset of epidural analgesia. Increases in both the pH and PCO2 of the local anaesthetic are necessary to hasten onset. However, carbon dioxide can diffuse from local anaesthetic solutions following alkalinization with sodium bicarbonate and change both the pH and PCO2 of the mixture. This study examined changes in pH and PCO2 of three local anaesthetics reported to have a faster onset of analgesia following mixture with sodium bicarbonate and examined the effects of time and the local anaesthetic container air/liquid interface on the pH and PCO2 of the buffered local anaesthetic solutions. Bupivacaine 0.5%, lidocaine 2%, and chloroprocaine 2% were each buffered with sodium bicarbonate. The pH and PCO2 of each solution were measured at time 0 and at 5, 10, 15, 20, 30, 40, 50 and 60 min intervals. The solutions were placed in containers as follows: 30 ml in 40 ml containers, 10 ml in 40 ml containers, 10 ml in 13 ml containers, and 10 ml in polypropylene syringes. The pH and PCO2 increased following alkalinization but gradually decreased in all containers except in polypropylene syringes.

UI MeSH Term Description Entries
D008012 Lidocaine A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of PROCAINE but its duration of action is shorter than that of BUPIVACAINE or PRILOCAINE. Lignocaine,2-(Diethylamino)-N-(2,6-Dimethylphenyl)Acetamide,2-2EtN-2MePhAcN,Dalcaine,Lidocaine Carbonate,Lidocaine Carbonate (2:1),Lidocaine Hydrocarbonate,Lidocaine Hydrochloride,Lidocaine Monoacetate,Lidocaine Monohydrochloride,Lidocaine Monohydrochloride, Monohydrate,Lidocaine Sulfate (1:1),Octocaine,Xylesthesin,Xylocaine,Xylocitin,Xyloneural
D011126 Polypropylenes Propylene or propene polymers. Thermoplastics that can be extruded into fibers, films or solid forms. They are used as a copolymer in plastics, especially polyethylene. The fibers are used for fabrics, filters and surgical sutures. Propene Polymers,Propylene Polymers,Hostalen,Marlex,Marlex Polypropylene,Polypro,Polypropylene,Prolene,Polymers, Propene,Polymers, Propylene,Polypropylene, Marlex
D011343 Procaine A local anesthetic of the ester type that has a slow onset and a short duration of action. It is mainly used for infiltration anesthesia, peripheral nerve block, and spinal block. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1016). Anuject,Geriocaine,Gerokit,Hewedolor-Procain,Lophakomp-Procain N,Novocain,Novocaine,Procain Braun,Procain Jenapharm,Procain Rödler,Procain Steigerwald,Procain curasan,Procaina Serra,Procaine Hydrochloride,Pröcaine chlorhydrate Lavoisier,Röwo Procain,procain-loges,Hydrochloride, Procaine
D002021 Buffers A chemical system that functions to control the levels of specific ions in solution. When the level of hydrogen ion in solution is controlled the system is called a pH buffer. Buffer
D002045 Bupivacaine A widely used local anesthetic agent. 1-Butyl-N-(2,6-dimethylphenyl)-2-piperidinecarboxamide,Bupivacain Janapharm,Bupivacain-RPR,Bupivacaina Braun,Bupivacaine Anhydrous,Bupivacaine Carbonate,Bupivacaine Hydrochloride,Bupivacaine Monohydrochloride, Monohydrate,Buvacaina,Carbostesin,Dolanaest,Marcain,Marcaine,Sensorcaine,Svedocain Sin Vasoconstr,Bupivacain RPR
D002245 Carbon Dioxide A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. Carbonic Anhydride,Anhydride, Carbonic,Dioxide, Carbon
D006863 Hydrogen-Ion Concentration The normality of a solution with respect to HYDROGEN ions; H+. It is related to acidity measurements in most cases by pH pH,Concentration, Hydrogen-Ion,Concentrations, Hydrogen-Ion,Hydrogen Ion Concentration,Hydrogen-Ion Concentrations
D000388 Air The mixture of gases present in the earth's atmosphere consisting of oxygen, nitrogen, carbon dioxide, and small amounts of other gases.
D000468 Alkalies Usually a hydroxide of lithium, sodium, potassium, rubidium or cesium, but also the carbonates of these metals, ammonia, and the amines. (Grant & Hackh's Chemical Dictionary, 5th ed) Alkali,Alkalis
D000772 Anesthesia, Local A blocking of nerve conduction to a specific area by an injection of an anesthetic agent. Anesthesia, Infiltration,Local Anesthesia,Neural Therapy of Huneke,Huneke Neural Therapy,Infiltration Anesthesia

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