Possible Interaction: Anesthetics, Local and Epinephrine

“It is widely accepted that local anesthetics with epinephrine should not be used in areas served by terminal vessels.”

“In young children, epidural anesthesia induces an increase in cardiac output only when adrenaline is added to local anesthetics , probably through its systemic absorption from the epidural space.”

“Background and Objectives: Epinephrine is used with local anesthetics to prolong the duration of epidural analgesia and decrease the peak plasma concentrations of local anesthetics.”

“BACKGROUND Local anesthetic nerve block prolonged by epinephrine is thought to result from local vasoconstriction and consequent decreased local anesthetic clearance from the injection site.”

“Firstly, the presence of 0.15 mg of adrenaline in the local anaesthetic solution used conferred little, if any, prophylaxis against bronchospasm.”

“Two‐way analysis of variance showed that the addition of adrenaline to the local anaesthetic solution , but not the choice of using arterial or venous serum for analysis, significantly correlated to the lowering of the S‐K concentration (P <0.001).”

“ Epinephrine added to the local anesthetic solution significantly increased the duration of action of both drugs.”

“In addition, various agents such as antibiotics, preservatives, opioids, epinephrine , and propofol can combine with LAs and affect their antimicrobial properties through synergistic or antagonistic action.”

“It can be concluded that potentially significant amounts of epinephrine can be absorbed systemically from the local anesthetic solution , that secretion of endogenous epinephrine in response to stress occurs, often at levels sufficient to cause measurable changes in hemodynamic variables, and that absorption of epinephrine from impregnated strings occurs.”

“According to the pharmaceutical guidelines, the use of epinephrine as an additive to local anesthetics is contraindicated for these areas.”