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Epinephrine in digital blocks: refuting dogma

Published online by Cambridge University Press:  21 May 2015

Peter G. Katis
Peter G. Katis*
Affiliation:
Emergency Medicine, University Health Network, Toronto, Ont.; Department of Family and Community Medicine, University of Toronto, Toronto
*
Toronto General Hospital, R. Fraser Elliot Building, GS-434, 200 Elizabeth St., Toronto ON M5G 2C4; 416 340-3856, fax 416 340-4300, [email protected]

Abstract

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In the medical community there is a widely held belief that epinephrine should not be used with lidocaine when attempting a digital block because it will cause tissue gangrene. This belief is reinforced by several of the more prominent emergency textbooks, but a review of the medical literature fails to reveal a sound basis for this dogma.

Keywords

lidocaineepinephrinefinger
Type
Medical Mythology • Mythes médicaux
Information
Canadian Journal of Emergency Medicine , Volume 5 , Issue 4 , July 2003 , pp. 245 - 246
Copyright
Copyright © Canadian Association of Emergency Physicians 2003

References

1.Ganong, WF.Review of medical physiology. 17th ed. Norwalk: Appleton & Lange; 1995. p. 330.Google Scholar
2.Liebelt, E, Levick, N.Acute pain management, analgesia, and anxiolysis in the adult patient. In: Tintinalli, J, Kelen, G, Stapczynski, J, editors. Emergency medicine: a comprehensive study guide. 5th ed. New York: McGraw-Hill; 2000. p. 251–68.Google Scholar
3.Simon, B, Hern, HG.Wound management principles. In: Marx, J, editor. Rosen’s emergency medicine: concepts and clinical practice. 5th ed. St. Louis: Mosby; 2002. p. 737–51.Google Scholar
4.Wilhelmi, BJ, Blackwell, SJ, Miller, J, Mancoll, JS, Phillips, LG.Epinephrine in digital blocks: revisited. Ann Plast Surg 1998;41(4):410–4.Google Scholar
5.Wilhelmi, BJ, Blackwell, SJ, Miller, JH, Mancoll, JS, Dardano, T, Tran, A, et al. Do not use epinephrine in digital blocks: myth or truth? Plast Reconstr Surg 2001;107(2):393–7.Google Scholar
6.Sylaidis, P, Logan, A.Digital blocks with adrenaline: an old dogma refuted. J Hand Surg [Br] 1998;23(1):17–9.Google Scholar
7.Denkler, K.A comprehensive review of epinephrine in the finger: to do or not to do. Plast Reconstr Surg 2001;108(1):114–24.Google Scholar
8.Baek, SM, Kim, SS.Successful digital replantation after 42 hours of warm ischemia. J Reconstr Microsurg 1992;8(6):455–8.Google Scholar