[Local anaesthetics containing epinephrine for use in the hand and fingers]

In the Netherlands there is no consensus regarding the addition of epinephrine (adrenaline) to local anaesthetics for use in the fingers. This is based on the persistent belief that the addition of epinephrine to local anaesthetics for use in the fingers is contraindicated due to the risk of ischaemic complications. Ischaemic complications arising from the use of modern anaesthetics containing epinephrine have, however, never been described. The addition of epinephrine results in a reduced arterial blood-flow and has several benefits, such as reduced blood loss and extended duration of anaesthesia. Local anaesthesia containing epinephrine enables relatively extensive surgical procedures to be carried out on the extremities without the customary use of a tourniquet. Preoperative threat of reduced circulation in the fingers is a contraindication for the use of local anaesthetics with added epinephrine.