Rafi Sheikh
Research project participant
Maximal haemostatic effect is attained in porcine skin within 7 minutes of the administration of a local anaesthetic together with epinephrine, refuting the need for a 30-minute waiting time
Author
Summary, in English
Objective
Based on clinical experience gained over many years, the maximal haemostatic effect following administration of local anaesthetics containing epinephrine is generally believed to occur within 10 minutes. Surprisingly, it was found in a recent study, in which bleeding was quantified intraoperatively, that maximal haemostasis did not occur until 30 minutes. If this is indeed the case, then it would be necessary to extend the preoperative waiting time to minimize perioperative bleeding.
We have carried out a carefully controlled study on the time delay between administration of a local anaesthetic containing epinephrine and maximal haemostasis in a surgical setting.
Methods
Lidocaine 20 mg/ml (2 %) or lidocaine + epinephrine 12.5 µg/ml (1:80 000) was injected into the skin of eight pig flanks. Bleeding was induced after 3, 5, 7, 15 and 30 minutes by making a 10 mm incision at each injection site. Blood was collected for 1 minute and weighed.
Results
A gradual reduction in bleeding was observed, with maximal reduction after only 7 minutes (54 %, p<0.05, 95% CI: 44 - 64%). No further significant reduction in bleeding was observed (62% at 15 and 66% at 30 min, p = n.s. compared to 7 min).
Conclusions
Maximal haemostatic effect in the current setting was observed within 7 minutes of injection of lidocaine with epinephrine. This is in good agreement with previous empirical findings, and we see no reason to prolong the preoperative waiting time.
Based on clinical experience gained over many years, the maximal haemostatic effect following administration of local anaesthetics containing epinephrine is generally believed to occur within 10 minutes. Surprisingly, it was found in a recent study, in which bleeding was quantified intraoperatively, that maximal haemostasis did not occur until 30 minutes. If this is indeed the case, then it would be necessary to extend the preoperative waiting time to minimize perioperative bleeding.
We have carried out a carefully controlled study on the time delay between administration of a local anaesthetic containing epinephrine and maximal haemostasis in a surgical setting.
Methods
Lidocaine 20 mg/ml (2 %) or lidocaine + epinephrine 12.5 µg/ml (1:80 000) was injected into the skin of eight pig flanks. Bleeding was induced after 3, 5, 7, 15 and 30 minutes by making a 10 mm incision at each injection site. Blood was collected for 1 minute and weighed.
Results
A gradual reduction in bleeding was observed, with maximal reduction after only 7 minutes (54 %, p<0.05, 95% CI: 44 - 64%). No further significant reduction in bleeding was observed (62% at 15 and 66% at 30 min, p = n.s. compared to 7 min).
Conclusions
Maximal haemostatic effect in the current setting was observed within 7 minutes of injection of lidocaine with epinephrine. This is in good agreement with previous empirical findings, and we see no reason to prolong the preoperative waiting time.
Department/s
- Ophthalmology Imaging Research Group
- Ophthalmology, Lund
Publishing year
2019-03
Language
English
Pages
77-81
Publication/Series
JPRAS Open
Volume
19
Document type
Journal article
Publisher
Elsevier
Topic
- Surgery
Status
Published
Research group
- Ophthalmology Imaging Research Group
ISBN/ISSN/Other
- ISSN: 2352-5878