Document Detail


Do not use epinephrine in digital blocks: myth or truth? Part II. A retrospective review of 1111 cases.
MedLine Citation:
PMID:  20697319     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Epinephrine in digital blocks has been condemned by traditional medical theory. The authors provide a retrospective review of 1111 cases involving digital block anesthesia with epinephrine in conjunction with an extensive literature review.
METHODS: The authors conducted a retrospective review of 1111 cases involving digital and hand surgery. Observations were made concerning the location of and indication for surgery, age, sex, type of block used, type and dose of anesthetic, use of epinephrine and concentration, use of a tourniquet, follow-up, and complications. Dorsal and transthecal techniques were used exclusively. Patients with vascular compromise did not receive epinephrine and were excluded from the study.
RESULTS: One thousand one hundred eleven cases were reviewed, distributed among 692 male patients and 419 female patients. Sites of surgery ranged throughout the hand and all fingers for a variety of indications. Five hundred patients received injections of 1% plain lidocaine with a dosage range of 2 to 10 cc and an average of 5.7 cc. Six hundred eleven patients received injections of 1% lidocaine with epinephrine (1:100,000) in a dose range of 0.5 to 10 cc and an average dose of 4.33 cc. Nine hundred eighty-six patients (88.75 percent) followed up in the clinic. No patients suffered from digital gangrene in the epinephrine group.
CONCLUSIONS: After reviewing 1111 cases, there were no complications associated with the use of epinephrine in digital blocks. The authors suggest that correct application of epinephrine in digital blocks is appropriate, and defend its use.
Authors:
Saeed Chowdhry; Lynn Seidenstricker; Damon S Cooney; Ron Hazani; Bradon J Wilhelmi
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  126     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-07     Completed Date:  2011-01-07     Revised Date:  2011-09-09    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2031-4     Citation Subset:  AIM; IM    
Affiliation:
University of Louisville, Louisville, KY, USA. sachowdhry22@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Dose-Response Relationship, Drug
Epinephrine / administration & dosage,  adverse effects*
Female
Finger Injuries / surgery*
Fingers / pathology
Follow-Up Studies
Gangrene
Hand / pathology
Hand Injuries / surgery*
Humans
Infant
Lidocaine / administration & dosage,  adverse effects*
Male
Middle Aged
Mythology*
Nerve Block / adverse effects*
Reconstructive Surgical Procedures*
Retrospective Studies
Tourniquets / adverse effects
Young Adult
Chemical
Reg. No./Substance:
137-58-6/Lidocaine; 51-43-4/Epinephrine
Comments/Corrections
Comment In:
Plast Reconstr Surg. 2011 Aug;128(2):598-9   [PMID:  21788871 ]
Plast Reconstr Surg. 2010 Dec;126(6):2035-6   [PMID:  21124142 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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