title: Arthroscopic shoulder surgery with epinephrine saline irrigation.
abstract: OBJECTIVE
  To determine whether dilute epinephrine saline irrigation (0.33 mg/L) delivered by a pressure-controlled pump would significantly reduce intraoperative bleeding during routine arthroscopic shoulder surgery and, in addition, to investigate potential adverse cardiovascular reactions of adding epinephrine to the irrigation fluid.
  
  
  METHODS
  Prospective, randomized, double-blinded, placebo-controlled study.
  
  
  METHODS
  Fifty-four patients requiring arthroscopic shoulder surgery were randomly assigned to either an epinephrine group that received dilute epinephrine irrigation by a pressure-controlled pump or to a placebo group that received plain saline irrigation by a pressure-controlled pump. Intraoperative, intra-articular bleeding was estimated by multiplying the total volume of the irrigation fluid used with the hemoglobin concentration in the irrigation fluid. Postoperatively, the surgeon rated the clarity of the visual field during the arthroscopy by a visual analogy scale.
  
  
  RESULTS
  Intraoperative bleeding was significantly reduced (P =.008) and the clarity of the visual field was significantly better (P =.0007) in the group of patients receiving dilute epinephrine irrigation compared with the group of patients without epinephrine added to the irrigation fluid.
  
  
  CONCLUSIONS
  The addition of epinephrine to irrigation fluid seems to reduce intra-articular bleeding during routine arthroscopic shoulder surgery and may improve visualization. Furthermore, no cardiovascular adverse reactions were observed resulting from the intra-articular epinephrine administration.
authors.affiliation: Departments of Orthopedics, Køge Hospital, Køge, Denmark.
authors.forename: K H
authors.initials: KH
authors.lastname: Jensen
authors.forename: K
authors.initials: K
authors.lastname: Werther
authors.forename: V
authors.initials: V
authors.lastname: Stryger
authors.forename: K
authors.initials: K
authors.lastname: Schultz
authors.forename: B
authors.initials: B
authors.lastname: Falkenberg
mesh_terms: D000328:Adult; D001182:Arthroscopy; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D004311:Double-Blind Method; D004837:Epinephrine / Q000008:administration & dosage*; D006801:Humans; D007270:Injections, Intra-Articular; D008875:Middle Aged; D012785:Shoulder Joint / Q000601:surgery*; D012965:Sodium Chloride / Q000008:administration & dosage; D007507:Therapeutic Irrigation / Q000379:methods*
chemical_list: D012965:Sodium Chloride; D004837:Epinephrine