Effects of epinephrine in local anesthetic mixture

Authors: Sinan Karaoglu Kudret Dogru Sevki Kabak Muharrem Inan Mehmet Halici

Publish Date: 2001/11/23

Volume: 10, Issue: 4, Pages: 226-228

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Abstract

We compared three different methods of anesthesia for outpatient knee arthroscopy in terms of perioperative surgical conditions pain and hemodynamics In a prospective and doubleblind study n=130 the patients were randomized into three groups A 50ml mixture composed of 20 ml 05 bupivacaine hydrochloride 10 ml 2 lidocaine hydrochloride and 20 ml 09 sodium chloride was prepared for local anesthesia The knee joint was injected with 40 ml of the mixture The portal sites were then injected with 10 ml of the mixture in group I Using the same technique 250 µg epinephrine was added to the same mixture in group II In group III the knee joint was injected with 40 ml of the mixture and only 50 µg epinephrine was then added to 10 ml of the mixture left before the portal site injections A tourniquet was not used There were some statistically significant changes in hemodynamic data Also the data on visual analogue scale scores time of arthroscopy and amount of liquid used for intraarticular flushing in group II and III were significantly lower than those in group I According to our experience bleeding in arthroscopy comes mostly from portal incision to intraarticular field except when performing extensive synovial shaving ligament reconstruction and lateral retinacular release Therefore when hemostasis is obtained at portals the arthroscopic view becomes clearer We think that adding epinephrine to only portal site injections is sufficient to obtain a clear view and furthermore when carrying out arthroscopy in this manner no significant changes are encountered in heart rate mean arterial pressure pain during arthroscopy or time of arthroscopy

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