title: Effect of different epinephrine concentrations on local bleeding and hemodynamics during dermatologic surgery.
abstract: In local anesthesia, various epinephrine concentrations are applied for its vasoconstrictive effect. This study was conducted to observe the effect of epinephrine on intraoperative bleeding and also to evaluate hemodynamic changes during skin surgery. Ninety-six patients scheduled for skin surgery under local anesthesia were divided into three groups administered three different concentrations of epinephrine (1:50,000, 1:100,000 and 1:200,000) with 1% lidocaine (an average of 5.7 mL). The rate of bleeding and hemodynamic changes were assessed during surgical procedure. The surgeon's rating of intraoperative bleeding was significantly lower in the group administered epinephrine concentration of 1:50,000 as compared with the group on epinephrine concentration of 1:200,000. However, there was no significant difference between the groups administered epinephrine concentrations of 1:200,000 and 1:100,000. Except for diastolic blood pressure at 1 min after injection of local anesthetics, transient changes of hemodynamic parameters were observed, with no statistically significant difference among the three anesthetic solutions used. It is concluded that, for local anesthesia, the rate of intraoperative bleeding is influenced by epinephrine concentration, and that 1:50,000 epinephrine provides optimal clinical efficacy for the local bleeding control during dermatologic surgery.
authors.affiliation: Department of Anesthesia, Razi Hospital, Teheran University of Medical Sciences,Tehran, Iran. m.shorooghi@yahoo.com
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Shoroghi
authors.forename: Seyed Hossein
authors.initials: SH
authors.lastname: Sadrolsadat
authors.forename: Mahmood
authors.initials: M
authors.lastname: Razzaghi
authors.forename: Farshid
authors.initials: F
authors.lastname: Farahbakhsh
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Sheikhvatan
authors.forename: Mahmood
authors.initials: M
authors.lastname: Sheikhfathollahi
authors.forename: Ali
authors.initials: A
authors.lastname: Abbasi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D004305:Dose-Response Relationship, Drug; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012871:Skin Diseases / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D014662:Vasoconstrictor Agents; D004837:Epinephrine