The Onpharma system buffers anesthetic cartridges toward physiologic pH before injection resulting in faster onset and a more comfortable and profound injection
Injecting pH-buffered lidocaine with epinephrine is more comfortable than injecting traditional non-buffered lidocaine with epinephrine, according to 17 peer-reviewed published studies.1-17
Onpharma provides practitioners a way to buffer the anesthetic immediately before the injection ex vivo (outside the body), rather than the traditional in vivo (inside the body) buffering process which relies on the patient’s physiology to buffer the anesthetic. Bringing the pH of the anesthetic toward physiologic before injection may have an important effect on injection comfort.
Fourteen dentists participated in Dental Product Shopper’s evaluation of Onpharma’s Precision Local Anesthetic Buffering System rating features such as ease of incorporating into clinical practice, patient comfort during injection, effectiveness in reducing anesthetic onset time, and profoundness of local anesthetic.
Ease of Incorporating into Clinical Practice
Consisting of 3 separate products––Onpharma Sodium Bicarbonate Inj., 8.4% USP Neutralizing Additive Solution, Onset Mixing Pen, and the Onset Cartridge Connector, the Precision Local Anesthetic Buffering System is the first and only automated and convenient way to adjust the pH of lidocaine with epinephrine cartridges at chairside immediately before injection.
When evaluators were asked to rate the ease of incorporating the Onpharma system into their practice, 11 rated it as excellent and 3 rated it as very good. One evaluator with 19 years in practice said that he “was able to start working immediately following the injection and that it has reduced my procedure time.”
Patient Comfort During Injection
All 14 dentists who participated in this evaluation said patient comfort was very important to important when purchasing an anesthesic system.
When the evaluators were asked to rate the overall patient comfort of the Onpharma system, 11 rated it as excellent, and 3 rated it as very good. One evaluator said, “Amazing product for initial injection. Thrilled to provide this new level of comfort to my patients.” Another evaluator said, “The other day, the police chief in our city stood up after a filling and said, ‘I didn’t feel a thing’.”
Effectiveness in Reducing Anesthetic Onset Time
According to Onpharma, the Precision Local Anesthetic Buffering System offers a simple way to adjust the pH of a lidocaine cartridge immediately before injection in a process that takes about 10 seconds.
When the evaluators were asked to rate the product’s effectiveness in reducing the anesthetic onset time, 12 rated it as excellent and 2 rated it as very good. One evaluator from Lancaster, PA, said, “the rapid onset of mandibular block anesthesia is a great time savings to me and the patients are very pleased to not have to ‘sit and wait’.” Another evaluator, who asked his patient how he would rate the injections he received said, “What injections?”
Profoundness of Local Anesthetic
When evaluators were asked to rate the profoundness of the local anesthetic when using the Onpharma system, 11 rated it as excellent, 2 rated it as very good, and 1 rated it as poor. When asked what he liked best about this product, one evaluator said,“The profoundness of anesthesia. I never have to re-inject especially on the mandibular blocks. It is pretty much instant profound anesthsia.”
Overall Satisfaction
When the evaluators were asked if they would recommend the Onpharma system to their colleagues, all of them said definitely. When asked if they would purchase it in the future, all 14 evaluators said definitely.
At the end of the evaluation, the dentists who participated were asked to give their overall satisfaction rating of the Precision Local Anesthetic Buffering System. Twelve evaluators gave the system an overall satisfaction rating of excellent, 1 rated it as very good, and 1 rated it as good. One evaluator said, “There is nothing more stressful and frustrating than sitting down to begin a procedure and having to stop to reinject. Onset has eliminated almost all of that.”
References
1. Momsen OH, Roman CM, Mohammed BA, Andersen G, Neutralization of Lidocaine-Adrenaline, A Simple Method for Less Painful Application of Local Anesthesia, Ugeskr Laeger, Vol. 162, No. 33, P. 4391 (2000).
2. Bowles WH, Frysh H, Emmons R, Clinical Evaluation of Buffered Local Anesthetic, General Dentistry, Vol. 43, No. 2, P. 182 (1995).
3. Lugo-Janer G, Padial M, Sanchez JL, Less Painful Alternatives for Local Anesthesia, J Dermatol Surg Oncol, vol. 19, pp. 237-40 (1993).
4. Christoph RA, Buchannan L, Begalla K, Schwartz S, Pain Reduction in Local Anesthetic Administration Through pH Buffering, Annals of Emergency Medicine, Vol. 17, No. 2, P 117 (1988).
5. Vossinakis IC, Stavroulaki P, Paleochorlidis I, Badras LS, Reducing the Pain Associated with Local Anesthetic Infiltration for Open Carpal Tunnel Decompression, British Journal of Hand Surgery, Vol. 4, No. 29B, P. 399 (2004).
6. Samdahl F, Arctander K, Skollborg K, Amland PF, Alakalization of Lignocane-Adrenaline Reduces the Amount of Pain During Subcutaneous Injection of Local Anesthetic, Scandanavian Journal of Plastic and Reconstructive Hand Surgery, Vol. 28, P. 33 (1994).
7. Martin AJ, pH-Adjustment and Discomfort Caused by the Intradermal Injection of Lignocaine, Anesthesia, P. 975, Vol. 45 (1990) (pH 3,76).
8. Masters JE, Randomized Control Trial of pH-buffered Lignocaine with Adrenaline in Outpatient Operations, British Journal of Plastic Surgery, P. 385, Vol. 51 (1998) (pH 3.51).
10. Younis I, Bhutiani RP, Taking the ’Ouch’ Out - Effect of Buffering Commercial Xylocaine on Infiltration and Procedure Pain - a Prospective, Randomised, Double-Blind, Controlled Trial, Annals of the Royal College of Surgeons of England, Vol 86, P. 213 (2004).
11. Fitton AR, Ragbir M, Milling AP, The Use of pH Adjusted Lignocaine in Controlling Operative Pain in the Day Surgery Unit: A Prospective, Randomized Trial, British Journal of Plastic Surgery, Vol. 49, P. 404 (1996).
12. Metzinger SE, Rigby PL, Bailey DJ, Brousse RG, Local Anesthetic in Blepharoplasty, A New Look?, Southern Medical Journal, Vol. 87, No. 2, P. 225 (1994).
13. Carvalho B, Fuller A, Brummel C, Cohen SE, Local Infiltration of Epinephrine-Containing Lidocaine with Bicarbonate Reduces Superficial Bleeding and Pain During Labor Epidural Catheter Insertion: A Randomized Trial, Intern J Obstetric Anesth, Vol 16, P. 116 (2007).
14. Yuen VH, Dolman PJ, Comparison of Three Modified Lidocaine Solutions for Use in Eyelid Anesthesia, Ophthalmic Plastic and Reconstructive Surgery, Vol.15, No. 2, P 143 (1999).
15. Talu H, Elibol O, Yanyali A, Karabas L, Alp B, Caglar Y, Effect of Warming and Buffering Lidocaine on Pain During Facial Anesthesia, Annals of Ophthalmology, vol. 33, no. 1, pp. 43-47 (2001).
16. Burns CA, Ferris G, Feng C, Cooer JZ, Brown MD, Decreasing the Pain of Local Anesthesia: A Prospective, Double-Blind Comparison of Buffered Premixed 1% Lidocaine with Epinephrine Versus 1% Lidocaine Freshly Mixed with Epinephrine, Journal of the Am. Academy of Derm., Vol. 54, No. 1, P. 128 (2006).
17. Stewart JH, Cole GW, Klein JA, Neutralized Lidocaine with Epinephrine for Local Anesthesia, J Dermatol Surg Oncol, vol. 15, no. 10, p. 1081 (1989).
