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Related Experiment Videos

Revisiting epinephrine in foot surgery.

Philip Radovic1, Robert G Smith, Don Shumway

  • 1Aestheticare Outpatient Surgery Center, San Juan Capistrano, CA 92675, USA.

Journal of the American Podiatric Medical Association
|March 20, 2003
PubMed
Summary

Epinephrine in local anesthetics is safe and beneficial for foot and digit procedures in selected patients. This approach reduces complications, enhances anesthesia duration, and minimizes post-operative pain medication needs.

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Area of Science:

  • Anesthesiology
  • Podiatric Surgery
  • Vascular Pharmacology

Background:

  • Historically, anesthetics with epinephrine were contraindicated in the extremities, particularly the digits, due to concerns about vasoconstriction.
  • Emerging evidence challenges this long-held belief, suggesting potential benefits in specific clinical scenarios.

Purpose of the Study:

  • To evaluate the safety and efficacy of local anesthetics containing epinephrine in foot and ankle procedures.
  • To assess the impact of epinephrine on anesthetic duration, postoperative pain, and complication rates in the extremities.

Main Methods:

  • Retrospective review of over 150 patients undergoing foot and ankle surgery.
  • Analysis of complication rates, anesthetic efficacy, and need for postoperative analgesia in patients receiving local anesthetics with epinephrine.

Main Results:

  • No complications were reported in the foot and ankle among the reviewed patients.
  • Observed benefits included decreased local anesthetic plasma concentrations and prolonged anesthesia duration.
  • Reduced need for postoperative narcotics and decreased incidence of hemorrhage and hematoma were noted, without evidence of vascular occlusion.

Conclusions:

  • Local anesthetics containing epinephrine can be safely used in the foot and ankle in appropriately selected patients.
  • Epinephrine administration in this context offers significant advantages, including improved anesthetic outcomes and reduced postoperative morbidity.
  • The findings support a re-evaluation of the contraindication for epinephrine in extremity anesthesia.

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