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Research by Benoit and Lalonde establishes that buffering lidocaine with epinephrine using a 10:1 ratio of 1% anesthetic to 8.4% sodium bicarbonate significantly reduces injection pain by neutralizing acidity . This preparation, often used in WALANT surgery, brings the highly acidic mixture closer to physiological pH to enhance patient comfort . Read the full study at PMC . WALANT surgery of the hand: state of the art - PMC - NIH