Safety of Epinephrine in Digital Nerve Blocks: A Literature Review

Ilicki, Jonathan

doi:10.1016/j.jemermed.2015.05.038

Cited by 45 publications

(26 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, the literature suggests that a low dose of 1:100 000 used in digital surgery is thought to enhance the effects of local anaesthesia without complication, and suggest that higher doses of adrenaline and larger volumes of anaesthetic used lead to a damaging 'compartment syndrome' necrosis. [13][14][15] The balanced salt solution for infusion during the cataract surgery of these cases had a much lower dose of 1:1 000 000. A dilution error is only possible to 1:500 000 as there is only 1 mL in a standard ampoule of 1:1000 adrenaline.…”

Section: Discussionmentioning

confidence: 97%

“…The damaging vasoconstrictive effects of adrenaline in end‐organ surgery are widely acknowledged. However, the literature suggests that a low dose of 1:100 000 used in digital surgery is thought to enhance the effects of local anaesthesia without complication, and suggest that higher doses of adrenaline and larger volumes of anaesthetic used lead to a damaging ‘compartment syndrome’ necrosis . The balanced salt solution for infusion during the cataract surgery of these cases had a much lower dose of 1:1 000 000.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Paracentral acute middle maculopathy as a finding in patients with severe vision loss following phacoemulsification cataract surgery

Creese

Ong

Sandhu

et al. 2017

Clinical Exper Ophthalmology

View full text Add to dashboard Cite

PAMM should be considered in patients with 'patch off' visual loss and absence of other fundal signs. We hypothesise that spasm or transient occlusion of central retinal artery leads to arterial hypoperfusion with subsequent ischaemia or infarction of the retina. Underlying arterial disease may have led to pre-existing hypoperfusion that may have been further compromised by raised intraocular pressure during the procedure itself or via raised orbital pressure from the anaesthesia.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Paracentral acute middle maculopathy as a finding in patients with severe vision loss following phacoemulsification cataract surgery

Creese

Ong

Sandhu

et al. 2017

Clinical Exper Ophthalmology

View full text Add to dashboard Cite

show abstract

“…The traditional teaching is that epinephrine should not be used in fingers due to the fear that it could result in finger necrosis or gangrene. However, several comprehensive literature reviews have debunked this myth [7-8].…”

Section: Discussionmentioning

confidence: 99%

Traumatic Multi-Finger Amputations After Trying to Rein in a Horse

Mangal¹,

Stead

Ganti³

et al. 2019

Cureus

View full text Add to dashboard Cite

The authors present a case of traumatic, multiple partial-digit amputations caused by the patient entangling three of his fingers in the reins of a moving horse. The patient experienced amputation in fingers III-V on the dominant, right hand. The patient was stabilized and provided analgesia before referral to a surgical center for potential replantation. The emergency management of traumatic finger amputations is reviewed.

show abstract

“…Hemostasis during the procedure may be assisted with the addition of epinephrine to the anaesthetic, without further risk of vascular compromise. 5,6 Alternatively, a tourniquet may be safely used if only for a short duration. 7 Prior to performing the blockade, a focused neurologic exam may highlight any preexisting sensory anomalies.…”

Section: Anaesthesia: General Preparationmentioning

confidence: 99%