Spinoff of Lidocaine with IV - what about Lidocaine mixed with Rocephin?

[klone, MSN, RN]

Okay, so I read in the other thread about mixing Bicarb with Lidocaine to mitigate the burn. I didn't know Lidocaine caused pain. In OB, our providers inject it into the perineum before a repair after childbirth. I guess I figured Lidocaine = numbing. I never associated it with pain/burning.

We routinely reconstitute our ceftriaxone with Lidocaine instead of sterile water in order to help lessen the pain of the abx. But now I'm reading in the other thread that Lidocaine itself causes pain?

So should we be mixing bicarb with the lidocaine with the ceftriaxone?

[Jolie, BSN]

In my experience, Rocephin is much better tolerated (by both adults and children) when mixed with lidocaine.

I cant explain why lidocaine may burn in one instance, and lessen pain in another, but that seems to be the case.

[elijahvegas, ASN, RN, EMT-P]

Lidocaine generally burns before it numbs

[Khaan]

lidocaine temporarily causes nerve excitation, so yes. But it then suddenly causes depression of nerve signals.

[sallyrnrrt, ADN, RN]

a low velocity, slow injection, minimizes tissue expansion, and lessen any discomfort

[DowntheRiver]

Lido does burn but it goes away rather quickly. Usually, however, to prevent any discomfort we use a buffer to limit the discomfort.

[AJJKRN]

I believe that buffered lidocaine is suppose to burn less, maybe this is the added Bicarb? When we didn't have a shortage of it we were suppose to use buffered lidocaine prior to IV starts but I know just good old lidocaine burns like a witch! Maybe I found some decently reputable info on it: SODIUM BICARBONATE INJ., 8.4% USP NEUTRALIZING ADDITIVE SOLUTION Rx only Volume 2.7 mL per cartridge 2.7 mEq (1mEq/mL) Volume 1.7 mL per cartridge 1.7 mEq (1mEq/mL)