Local anesthesia in blepharoplasty: a new look?

Forty volunteers were asked to compare pain from injection of buffered versus unbuffered local anesthetics given for upper lid and lower lid blepharoplasty. The concentration of the solution was 1 part 8.4% sodium bicarbonate to 5 parts local anesthetic. The surgeons performing the operations were asked to identify any difference in onset of action, hemostasis, or duration of action. Thirty-five of the 40 patients found the buffered anesthetic to be less painful and better tolerated. No difference in hemostasis or duration of action was noted between the buffered or unbuffered solutions, but the buffered solution produced faster onset of action.