Search research articles

ABOUT JoVE

Overview Leadership Blog JoVE Help Center

AUTHORS

Publishing Process Editorial Board Scope & Policies Peer Review FAQ Submit

LIBRARIANS

Testimonials Subscriptions Access Resources Library Advisory Board FAQ

RESEARCH

JoVE Journal Methods Collections JoVE Encyclopedia of Experiments Archive

EDUCATION

JoVE Core JoVE Business JoVE Science Education JoVE Lab Manual Faculty Resource Center Faculty Site

Terms & Conditions of Use

Search research articles

Related Experiment Videos

Digital blocks with adrenaline. An old dogma refuted

P Sylaidis¹, A Logan

¹Department of Plastic Surgery, West Norwich Hospital, UK.

Journal of Hand Surgery (Edinburgh, Scotland)

|May 8, 1998

Summary

Adrenaline in local anesthesia for digital blocks in hand surgery was previously avoided due to vasospasm fears. This study found adrenaline only temporarily reduces digital blood flow, with persistent perfusion in all patients.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by

Same author

Mitochondria-targeted antioxidant MitoQ ameliorates ischaemia-reperfusion injury in kidney transplantation models.

The British journal of surgery·2021

Same author

Retinal blood flow in critical illness and systemic disease: a review.

Annals of intensive care·2020

Same author

Translatable mitochondria-targeted protection against programmed cardiovascular dysfunction.

Science advances·2020

Same author

Lipid metabolic differences in cows producing small or large milk fat globules: Fatty acid origin and degree of saturation.

Journal of dairy science·2019

Same author

Burns objective scar scale (BOSS): Validation of an objective measurement devices based burn scar scale panel.

Burns : journal of the International Society for Burn Injuries·2019

Same author

Investigating the intra- and inter-rater reliability of a panel of subjective and objective burn scar measurement tools.

Burns : journal of the International Society for Burn Injuries·2019

Area of Science:

Hand Surgery
Local Anesthesia
Vascular Physiology

Background:

Historically, adrenaline's use in hand surgery was limited due to concerns of ischemic necrosis.
A significant resistance to using adrenaline for digital anesthesia persists, despite its common use in palmar and dorsal hand surgery.
The primary concern is the potential for irreversible digital artery vasospasm.

Purpose of the Study:

To prospectively evaluate the effects of lignocaine with adrenaline on digital arterial blood flow.
To challenge the long-held belief that adrenaline causes irreversible digital artery vasospasm in hand surgery.

Main Methods:

A prospective study involving 100 consecutive patients undergoing digital blocks.
Administration of 2% lignocaine with 1:80,000 adrenaline for digital anesthesia.
Monitoring of various parameters of digital arterial blood flow.

Main Results:

Adrenaline caused only a temporary reduction in digital blood flow.
Digital artery perfusion was maintained in all patients throughout the study.
No cases of irreversible vasospasm or ischemic necrosis were observed.

Conclusions:

The use of adrenaline in digital blocks for hand surgery is safe and does not cause irreversible vasospasm.
Adrenaline can be safely used with local anesthetics for digital anesthesia, improving surgical conditions.
This study provides evidence to overcome historical reservations regarding adrenaline in digital anesthesia.

Related Experiment Videos