Vasoconstrictors in Facial Plastic Surgery

Millay, Donna J.; Larrabee, Wayne F.; Carpenter, Randall L.

doi:10.1001/archotol.1991.01870140048004

Cited by 32 publications

(15 citation statements)

References 8 publications

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“…The 20% degradation present at 24 hours in the open/exposed set should not affect hemostasis because epinephrine levels as low as 1:400,000 are known to be clinically effective 10,11 . In the open/exposed group, the pH gradually elevated from 7.22 ± 0.018 to 8.09 ± 0.044 over a 72‐hour interval; these specimens were noted to crystallize or precipitate beginning at 48 hours (see Figure 4).…”

Section: Resultsmentioning

confidence: 99%

Buffered Local Anesthetics and Epinephrine Degradation

Murakami

Odland

Ross

1994

The Journal of Dermatologic Surgery and Oncology

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Lidocaine with epinephrine is currently the most common local anesthetic agent used for facial soft tissue surgery. This combination is generally safe and effective in providing complete anesthesia and adequate hemostasis. Because epinephrine is unstable at physiologic pH, the commercial preparation is formulated with a low pH (3.5-5.5). Unfortunately, this acidic pH causes significant pain during infiltration. To reduce pain, clinicians sometimes buffer acidic local anesthetic agents with sodium bicarbonate. However, little is known about the stability of epinephrine when the pH of epinephrine is clinically altered. Using high pressure liquid chromatography (HPLC), epinephrine levels were measured after the addition of sodium bicarbonate. Our results indicate a significant amount of epinephrine degradation occurs in some of these specimens. Recommendations regarding the use of buffered local anesthetic agents are made.

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Section: Resultsmentioning

confidence: 99%

Buffered Local Anesthetics and Epinephrine Degradation

Murakami

Odland

Ross

1994

The Journal of Dermatologic Surgery and Oncology

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“…Local anesthetics are known to produce vasodilation in concentrations used clinically by their direct effect on the smooth muscles of vessel walls, with cocaine being the only exception 15,16 . Enlund et al 17 have reported that lidocaine may induce dose‐dependent arterial hypotension when combined with a defined level of general anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Marked Hypotension Induced by Adrenaline Contained in Local Anesthetic

Yang

Wang

et al. 2005

The Laryngoscope

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“…. Local anesthetics are known to produce vasoconstriction at very low concentrations; however, in concentrations used clinically, they produce vasodilation by direct effect on smooth muscles of vessel walls with cocaine as the only exception 7,8 . Cocaine is commonly used for its vasoconstrictor and anesthetic properties, which include rapid onset, prolonged duration of action, strong vasoconstriction, and excellent decongestant effects 9,10 .…”

Section: Discussionmentioning

confidence: 99%