Epinephrine with local during surgery

CHERYLKANEPPER said:

Anyone know how to screen a patient for undesireable reaction to epinephrine administration? It
would be given to me along with local anesthetic for minor surgery. I know about the hypertension
and I do have borderline hypertension and whitecoat hypertension. I would also take oral valium
prior to surgery. Thanks for any answers.

Why not simply ask to *not* receive the epinephrine since you are concerned about it?

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
heartmdphd.comheartmdphd.comOpen ↗

MD/PhD said:

CHERYLKANEPPER said:

Anyone know how to screen a patient for undesireable reaction to epinephrine administration? It
would be given to me along with local anesthetic for minor surgery. I know about the hypertension
and I do have borderline hypertension and whitecoat hypertension. I would also take oral valium
prior to surgery. Thanks for any answers.

Why not simply ask to *not* receive the epinephrine since you are concerned about it?

...............

Maybe because the epinephrine decreases bleeding and prolongs the effect of the local?

Cheryl, the amount of epinephrine in a local anestheitic is negligible. Unless large amounts of
anesthetic are used or unless the anesthetic is inadverently injected into a vein, there should be
no systemic effect whatsoever. Discuss your concerns with your doctor. There are pros and cons for
the use of epinephrine in a local. Generally the pros outweigh the cons - but do have that
discussion ... and together you can decide what's in your best interest.

You know, my definition of "major" surgery is *any* surgery that is done on me! :-)

I know you are concerned with your upcoming procedure - however minor
- and I do wish you well with it. In fact I can say with complete confidence that everybody here
does too! Everybody.

smn

The particular doctor I need to do the procedure must use it along with the local. The only other
option I may have is general anesthesia, which I refuse for any cosmetic procedure. This procedure
is little more than a skin cut.

FreespiritedFem said:

The particular doctor I need to do the procedure must use it along with the local. The only other
option I may have is general anesthesia, which I refuse for any cosmetic procedure. This procedure
is little more than a skin cut.

For such a small amount, it is unlikely you will feel something untoward with the small amount of
epinephrine mixed with the local anesthetic. This epinephrine is useful for local vasoconstriction
which should allow the local anesthetic to hang around longer.

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
heartmdphd.comheartmdphd.comOpen ↗

FreespiritedFem said:

Andrew, thanks for your anxiety-allaying answer.

You are welcome.

Quoted message said:

One more question though: could you tell me what would be the minimum and maximum amount of epi to
be put into the local, considering being enough to control bleeding and little enough to be safe.

Usual concentration is 1 mg per 1000 mls.

Quoted message said:

I read something about a safe amount being .018 to .038mg.

The actual amount will depend on the volume of the local anesthetic administered.

Quoted message said:

Also I've seen it written in another form such as 1:50,000. If it's any help, the cuts are for
the anterior mini facelift, the cuts no longer than 1 1/2 inch each (one on each side of the
head, naturally), with very little undermining. I read it's 6 to 8 sutures required (for each
cut, I assume) Thanks again so much! Sherry

You are probably going to get about 0.015 mg of epi (15 mls of local anesthetic).

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
heartmdphd.comheartmdphd.comOpen ↗

MD/PhD said:

Usual concentration is 1 mg per 1000 mls.

..............

Usual concentration is 5 mg per 1000 mls.

.................

Quoted message said:

You are probably going to get about 0.015 mg of epi (15 mls of local anesthetic).

.................

You are probably going to get about 0.075 mg of epi (15 mls of local anesthetic.

....................

Quoted message said:

Humbly,

Andrew

......................

Accurately,

smn

FreespiritedFem said:

Andrew, thanks again.

You're welcome :-)

Quoted message said:

I will check this against what the cosmetic surgeon tells me.

Good.

Quoted message said:

Hopefully there won't be too much of a difference. 🙂 Sherry

There shouldn't be.

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
heartmdphd.comheartmdphd.comOpen ↗

On 24 Jan 2004 02:00:05 GMT, [email hidden] (FreespiritedFem)
wrote (in part):

Quoted message said:

smn, thank you for your answers.

.............

Not a problem.

Hope all goes well.

smn