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Epinephrine in digital block: color Doppler flow imaging.
H Cevdet Altinyazar1, Hüseyin Ozdemir, Rafet Koca
1Department of Dermatology, Zonguldak Karaelmas University, Faculty of Medicine, 67600 Zonguldak, Turkey. antinyazar@karaelmas.edu.tr
Summary
Epinephrine in digital blocks causes temporary vasoconstriction, with blood flow returning to normal within 90 minutes. This study found epinephrine use safe for digital anesthesia in selected patients.
Area of Science:
- Anesthesiology
- Vascular Surgery
- Pharmacology
Background:
- Epinephrine is used in local anesthetics for vasoconstriction.
- Traditionally, epinephrine is avoided in digital blocks due to gangrene risk.
Purpose of the Study:
- To evaluate the vasoconstrictive effect of epinephrine in digital block anesthesia.
- To assess the safety and duration of epinephrine's effect in digital anesthesia.
Main Methods:
- 24 subjects received lidocaine with epinephrine for digital blocks.
- Digital artery blood flow was assessed using color Doppler ultrasonography.
- Doppler parameters (peak systolic velocity, end diastolic velocity, resistive index) were measured pre- and post-block.
Main Results:
- A significant decrease in blood flow and increase in resistive index occurred within 10 minutes.
- Four patients experienced temporary absence of blood flow, which resolved within 90 minutes.
- No local or systemic complications related to epinephrine were observed.
Conclusions:
- Epinephrine's vasoconstrictive effect in digital blocks is temporary, resolving within 60-90 minutes.
- Epinephrine appears safe for digital anesthesia in carefully selected patients.