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Re: The Intravaginal Slingpiasty Operation, a minimally invasive technique for cure of urinary incontinence in the female (1)
Author(s) -
Richardson Peter,
Laurie David
Publication year - 1997
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1997.tb02470.x
Subject(s) - sodium bicarbonate , anesthesia , urinary incontinence , medicine , local anaesthetic , bicarbonate , chemistry , urology , surgery , organic chemistry
EDITORIAL COMMENT: The following comment to this letter was provided by Dr Robert Cowie, Director of Anaesthesia, Mercy Hospital for Women: To maintain stability, local anaesthetic solutions are pH adjusted to be between 4.0–7.0 for plain solutions and 3.5‐5.0 for those containing adrenalin. This acidity is considered to be a prime cause of the burning sensation which can accompany subcutaneous infiltration. Numerous studies indicate that this stinging can be reduced by the addition of ImL sodium bicarbonate 8.4% to each 10mL of local anaesthetic solution. The resultant increase in the pH increases the nonionized basic form of the drug allowing better tissue perfusion, a higher concentration of the drug in the nerve axoplasm and a more rapid block of the sensory fibres. Neutralized lignocaine solutions remain stable for some time, those containing adrenalin for approximately I week. The addition of excessive bicarbonate will result in precipitation.