title: [Local anaesthesia with vasoconstrictor is safe to use in areas with end-arteries in fingers, toes, noses and ears].
abstract: For decades the commonly held belief that local anaesthesia (LA) with vasoconstrictor can cause necrosis in end-arteries has been sustained by medical teachers, text books and clinical practice. This literature review, identifying 24 articles investigating the use of LA with epinephrine in fingers, toes, noses and ears, including more than 15,000 patients, finds no evidence to support this belief. No case of necrosis has been reported since the introduction of commercial lidocaine with epinephrine in 1948. This review concludes that it is safe to use lidocaine with adrenaline in end-arteries.
authors.affiliation: Plastikkirurgisk Afdeling, Herlev Hospital, Herlev Ringvej 75, 2730 Herlev. yuppielea@hotmail.com.
authors.forename: Lea Juul
authors.initials: LJ
authors.lastname: Nielsen
authors.forename: Pavia
authors.initials: P
authors.lastname: Lumholt
authors.forename: Lisbet Rosenkrantz
authors.initials: LR
authors.lastname: Hölmich
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D000075203:Contraindications, Drug; D004423:Ear / Q000098:blood supply; D004837:Epinephrine / Q000008:administration & dosage* / Q000009:adverse effects; D005385:Fingers / Q000098:blood supply; D006801:Humans; D009336:Necrosis / Q000139:chemically induced; D009666:Nose / Q000098:blood supply; D014034:Toes / Q000098:blood supply; D014662:Vasoconstrictor Agents / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D004837:Epinephrine