Extreme Epinephrine Sensitivity With a General Anesthesia

Effects of Adding Epinephrine to Arthroscopic Irrigation Fluid on Cultured Chondrocyte Survival In Vitro

“…1 In another case report, an otherwise healthy 19-year-old patient undergoing reconstruction of the anterior cruciate ligament and transplantation of a meniscal allograft had florid pulmonary edema after the tibial tunnel was drilled during use of a dilute 1:3,333,333 epinephrine arthroscopic irrigation solution. 2 In both cases the likely factors responsible are an increased ␣-adrenergic agonist response to epinephrine 17,18 combined with rapid access to the systemic circulation through an intraosseous route.…”

How long to wait after local infiltration anaesthesia: systematic review

“…The face has pronounced capillary density 77 . LIA injected in this region has greater absorption and systemic effects compared to the rest of the body 46 , 78 , 79 . In eyelids, epinephrine’s latency is up to 7.0 min 29 .…”

Optimal Concentration of Epinephrine for Vasoconstriction in Ear Surgery

“…Three minutes after injection of lidocaine with 1:100,000 epinephrine in his ear canal and postauricular crease, the patient developed sinus tachycardia with short runs of bigeminy followed by bouts of pulmonary edema and hypotension that resolved with intensive care management over the next few days. 4 Wanamaker et al described two more cases, in 12-and 15-year-old patients undergoing tympanoplasty, that experienced acute onset of hypertension, tachycardia that progressed to ventricular tachycardia, and ultimately ventricular fibrillation. Subsequently, pulmonary edema developed from 3 and 8 mL, respectively, of 1:100,000 epinephrine infiltrated in standard fashion at the beginning of the case.…”