Document Detail

Tumescent anesthesia in ambulatory phlebectomy: addition of epinephrine.
MedLine Citation:
PMID:  10469074     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The advantages of using tumescent anesthesia for ambulatory phlebectomy have recently been described. Previously, tumescent solutions have avoided epinephrine for concerns of toxicity given the large volume of anesthetic sometimes used. OBJECTIVE: To evaluate the efficacy and safety of using epinephrine in the tumescent anesthesia solution during ambulatory phlebectomy. METHODS: Over the course of 1 year, epinephrine in the concentration of 1:100,000 was added to the tumescent solution of patients undergoing ambulatory phlebectomy. A retrospective review of 94 sequential patients was performed to determine the rate of complications associated with the procedure. RESULTS: The complication rate was considerably improved using tumescent lidocaine with epinephrine compared to a previously performed study of tumescent lidocaine without epinephrine. The rate of hematoma was decreased to nil while the rate of hyperpigmentation decreased from 3.6% to 0%. Overall, the rate of complications was improved when epinephrine was added to the tumescent lidocaine solution. Blood pressure measured every 5 minutes and heart rate measured continuously did not significantly change before, during or after infiltration of the anesthetic solution. CONCLUSIONS: Epinephrine in appropriate concentrations is clearly safe when used in the tumescent anesthetic solution during ambulatory phlebectomy and should be used to reduce the incidence of hematoma and hyperpigmentation.
D Keel; M P Goldman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]     Volume:  25     ISSN:  1076-0512     ISO Abbreviation:  Dermatol Surg     Publication Date:  1999 May 
Date Detail:
Created Date:  2000-08-16     Completed Date:  2000-08-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9504371     Medline TA:  Dermatol Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  371-2     Citation Subset:  IM    
Dermatology Associates of San Diego County, Inc., La Jolla, California 92037, USA.
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MeSH Terms
Ambulatory Surgical Procedures / adverse effects,  methods*
Anesthesia, Local / methods*
Anesthetics, Local / administration & dosage,  therapeutic use
Drug Therapy, Combination
Epinephrine / administration & dosage,  therapeutic use*
Follow-Up Studies
Injections, Subcutaneous
Lidocaine / administration & dosage,  therapeutic use
Medical Records
Middle Aged
Retrospective Studies
Treatment Outcome
Varicose Veins / surgery*
Vascular Surgical Procedures / adverse effects,  methods*
Vasoconstrictor Agents / administration & dosage,  therapeutic use*
Reg. No./Substance:
0/Anesthetics, Local; 0/Vasoconstrictor Agents; 137-58-6/Lidocaine; 51-43-4/Epinephrine

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

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