Alkalinizing local anesthetic does not decrease pain during injection for dorsal penile nerve block

Francis Serour, Arie Levine, Avigdor Mandelberg, Yoram Ben Yehuda, Mona Boaz, Jacques Mori

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Study Objective: To evaluate whether alkalizing local anesthetic with sodium bicarbonate reduces pain related to infiltration of local anesthetic during dorsal penile nerve block for circumcision.Design: Prospective, randomized, double-blind, controlled study.Setting: E. Wolfson Medical Center, Holon, Israel.Patients: 144 patients aged 15 to 54 years (mean ± SD = 22.7 ± 8.8 years), randomized before the block into four groups of 36 patients each.Interventions: Group A (control) received a standard solution of 1 mg/kg lidocaine 2% mixed with 0.5 mg/kg bupivacaine 0.5% without epinephrine (pH = 6.3). Patients in Group B, Group C, and Group D received this mixture added with 8.4% sodium bicarbonate for a mean final pH of 6.90, 7.16, and 7.43, respectively. Penile block was performed using a 23-gauge needle by an anesthetist who was blinded to the pH of the solution.Measurements and Main Results: Patients were questioned regarding pain suffered during injection of the anesthetic solutions by another physician who also was blinded to the drug used. Pain was rated by a previously reported subjective pain scale. Mean pain scales were 2.0 ± 0.17, 2.3 ± 0.15, 2.2 ± 0.16, and 1.94 ± 0.15 for Groups A to D, respectively. The differences between these results were not statistically significant.Conclusion: Alkalinizing the acidic local anesthetic solution by sodium bicarbonate does not decrease pain related to infiltration during penile nerve block for circumcision. Copyright (C) 1999 Elsevier Science Inc.

Original languageEnglish
Pages (from-to)563-566
Number of pages4
JournalJournal of Clinical Anesthesia
Issue number7
StatePublished - Nov 1999
Externally publishedYes


  • Anesthetics, local
  • Bicarbonate
  • Circumcision
  • Pain
  • Penile block


Dive into the research topics of 'Alkalinizing local anesthetic does not decrease pain during injection for dorsal penile nerve block'. Together they form a unique fingerprint.

Cite this