Optimal Time Delay of Epinephrine in One-Per-Mil Solution to Visualize Operation Field.

Area of Science:

• Hand Surgery
• Tumescent Anesthesia
• Microsurgery Visualization

Background:

• Optimizing epinephrine's role in tumescent solutions is crucial for surgical visualization.
• Understanding the ideal time delay for epinephrine's vasoconstrictive effects is key in hand surgery.

Purpose of the Study:

• To determine the optimal time delay for epinephrine in a 1:1,000,000 tumescent solution.
• To achieve enhanced visualization during hand surgery procedures.

Main Methods:

• Prospective, randomized, double-blind study involving 12 healthy male subjects.
• Epinephrine or normal saline solution injected into the ring finger pulp.
• Continuous oxygen saturation (SpO2) monitoring for 45 minutes post-injection.

Main Results:

• Epinephrine group showed a statistically significant decrease in SpO2 (P=0.002).
• Average delta SpO2 was significantly higher in the epinephrine group (3.42 ± 0.996) compared to saline (1.50 ± 1.567; P=0.001).
• Lowest SpO2 in the epinephrine group occurred at an average of 13.90 ± 5.38 minutes post-injection.

Conclusions:

• The optimal time delay for epinephrine in a 1:1,000,000 tumescent solution is approximately 13.90 ± 5.38 minutes.
• This timing is associated with maximal reduction in digital oxygen saturation, potentially improving surgical visualization.