Digital block with or without the addition of epinephrine in the anesthetic solution

Júnior, Almiro dos Reis; Quinto, Denise

doi:10.1016/j.bjane.2013.12.004

Cited by 9 publications

(4 citation statements)

References 38 publications

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“…Authors have recommended using caution with a circumferential ring of fluid due to pressure. 7 More research would have to be done regarding the location and volume of fluid, but digital necrosis is such a rare injury, and further research is difficult to produce.…”

Section: Discussionmentioning

confidence: 99%

Epinephrine-Containing Digital Nerve Block: A Case of Digital Tip Necrosis Leading to Amputation in a Patient With No Known Vascular, Rheumatologic, or Smoking History

Hong

Moontasri

Ratliff

2021

Journal of Hand Surgery Global Online

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Section: Discussionmentioning

confidence: 99%

Epinephrine-Containing Digital Nerve Block: A Case of Digital Tip Necrosis Leading to Amputation in a Patient With No Known Vascular, Rheumatologic, or Smoking History

Hong

Moontasri

Ratliff

2021

Journal of Hand Surgery Global Online

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“…The addition of clonidine to local anesthetics for peripheral nerve blocks extends the duration of analgesia and motor blockade by around 2 h. However, it increases the risk of hypotension, fainting, and sedation. When these two drugs are used together, they produce an additive inhibitory effect [71,[84][85][86][87][88][89].…”

Section: IV Oralmentioning

confidence: 99%

A Review of the Lidocaine in the Perioperative Period

Silva,

Mourão,

Vale

2023

JPM

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This review analyzes the controversies surrounding lidocaine (LIDO), a widely recognized local anesthetic, by exploring its multifaceted effects on pain control in the perioperative setting. The article critically analyzes debates about lidocaine’s efficacy, safety, and optimal administration methods. While acknowledging its well-documented analgesic attributes, the text highlights the ongoing controversies in its application. The goal is to provide clinicians with a comprehensive understanding of the current discourse, enabling informed decisions about incorporating lidocaine into perioperative protocols. On the other hand, emphasizes the common uses of lidocaine and its potential role in personalized medicine. It discusses the medication’s versatility, including its application in anesthesia, chronic pain, and cardiovascular diseases. The text recognizes lidocaine’s widespread use in medical practice and its ability to be combined with other drugs, showcasing its adaptability for individualized treatments. Additionally, it explores the incorporation of lidocaine into hyaluronic acid injections and its impact on pharmacokinetics, signaling innovative approaches. The discussion centers on how lidocaine, within the realm of personalized medicine, can offer safer and more comfortable experiences for patients through tailored treatments.

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“…Most of these studies were conducted before 1950, only 21 cases involving the use of epinephrine, 17 involving an unknown vasoconstrictor concentration, and none of them using lidocaine. On the other hand, researches show that the use of lidocaine with epinephrine in digital blocks seems to be safe, not causing digital gangrene [4][5][6][7] .…”

mentioning

confidence: 99%

Efeitos do uso de vasoconstritores no bloqueio de nervos digitais: revisão sistemática com metanálise

Neto

Costa

Veloso

et al. 2019

Rev. Col. Bras. Cir.

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RESUMO Convencionalmente, a associação de anestésicos locais com vasoconstritores é evitada em extremidades pelo risco de isquemia. Entretanto, estudos recentes sugerem haver segurança no uso de vasoconstritor em extremidades. Procuramos, assim, avaliar a efetividade e segurança do uso de vasoconstritores combinados com anestésicos locais no bloqueio de nervos digitais em comparação ao uso de anestésicos plenos, através de uma revisão sistemática com metanálise de ensaios clínicos randomizados. Pesquisamos, até maio de 2019, nas bases de dados MEDLINE, LILACS, SciELO, ScienceDirect, Scopus, ClinicalTrials.gov e literatura cinzenta, sem restrições de data ou idioma, os descritores: bloqueio digital, vasoconstritor e isquemia. Foram incluídos ensaios clínicos randomizados nos quais houve a utilização de anestésicos locais associados ou não a vasoconstritores em bloqueios digitais. Nas variáveis primárias foram analisadas a ocorrência de complicações isquêmicas e a duração da anestesia, e nas variáveis secundárias foram observadas necessidade de reaplicação anestésica, de controle de sangramento e latência. Dez estudos foram incluídos nesta revisão. Não foi observada a ocorrência de isquemia, independente do uso ou não de vasoconstritores. O uso de vasoconstritores na concentração de 1:100.000 ou menor esteve associado a maior duração da anestesia (P<0,00001), menor necessidade de reaplicação anestésica (P=0,02), menor necessidade de controle de sangramento (P=0,00006) e menor latência (P<0,00001). Pudemos concluir que uso de vasoconstritores associados a anestésicos locais no bloqueio digital mostrou-se uma técnica segura e efetiva.

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Digital block with or without the addition of epinephrine in the anesthetic solution

Abstract: The advantages of adding epinephrine to the anesthetic solution are minor when compared to the risks of the procedure, and it seems dangerous to use a vasoconstrictor in the fingers, unless the safety of the technique and the possibility of discarding the tourniquet are definitely proven.

Cited by 9 publications

References 38 publications

Epinephrine-Containing Digital Nerve Block: A Case of Digital Tip Necrosis Leading to Amputation in a Patient With No Known Vascular, Rheumatologic, or Smoking History

Epinephrine-Containing Digital Nerve Block: A Case of Digital Tip Necrosis Leading to Amputation in a Patient With No Known Vascular, Rheumatologic, or Smoking History

A Review of the Lidocaine in the Perioperative Period

Efeitos do uso de vasoconstritores no bloqueio de nervos digitais: revisão sistemática com metanálise

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