Lido with epi in SQ anesthesia

Q: What is the advantage of using epinephrine with lidocaine during subcutaneous (SQ) local anesthesia?

Answer:

When epinephrine is added to lidocaine during SQ infiltration, it provides local vasoconstriction which prolongs the duration of action of local anesthesia. This action may last up to three hours. Also, it provides added advantage of decrease local bleeding, and reduce systemic lidocaine absorption. 

 Said that combination of lidocaine and epinephrine for local anesthesia should be avoided for digital anesthesia in patients with peripheral artery disease (PAD).


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References:

1. Stanton-Hicks, MD . Local anesthetics: Pharmacology and clinical applications. Hosp Formul 1987; 22:156. 

2. Kennedy RM, Luhmann JD. The "ouchless emergency department". Getting closer: advances in decreasing distress during painful procedures in the emergency department. Pediatr Clin North Am 1999; 46:1215. 

3.  Hruza, GJ. Anesthesia. In: Dermatology, 2nd, Bolognia, JL, Jorizzo, JL, Rapini, RP (Eds), Mosby Elsevier, Spain 2008. Vol 2, p.2173.