The effect of adjuvant epinephrine concentration on the vasoactivity of the local anesthetics bupivacaine and levobupivacaine in human skin

    Research output: Contribution to journalArticle

    15 Citations (Scopus)

    Abstract

    The recommended optimal concentration of adjuvant epinephrine for use with local infiltration anesthesia is usually 5 µg/mL. However, a lower dose might be as effective at prolonging the anesthetic effects, while limiting the risk of hazards associated with unintentional intravascular injection. The aim of our study was to determine the lowest effective vasoconstrictor concentration of epinephrine in human skin for a range of doses of bupivacaine and its less-vasodilatory S(-) isomer, levobupivacaine. We injected combinations of 0.125%, 0.25%, and 0.75% bupivacaine and levobupivacaine with 1.25, 2.5, and 5 µg/mL epinephrine into the forearm skin of 10 healthy volunteers and measured the resulting blood flow changes over 1 hour using laser Doppler imaging. All 3 concentrations of epinephrine produced marked vasoconstriction, both alone and in combination with all 3 doses of the anesthetics (P < .001 in all cases). There was almost no difference in effect between the 3 epinephrine concentrations. We conclude that 1.25 µg/mL epinephrine produces a comparable vasoconstrictor effect in human skin to that of higher concentrations when coinjected with clinical doses of bupivacaine and levobupivacaine and may be equally effective for infiltration anesthesia.
    Original languageEnglish
    Pages (from-to)307-311
    Number of pages5
    JournalRegional Anesthesia and Pain Medicine
    Volume29
    Issue number4
    DOIs
    Publication statusPublished - 2004
    EventScottish Society for Experimental Medicine - Edinburgh, United Kingdom
    Duration: 22 Nov 200222 Nov 2002

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  • Research Output

    • 15 Citations
    • 2 Paper

    Activities

    • 4 Participation in conference

    World Congress on Regional Anaesthesia

    Graeme McLeod (Participant)

    29 May 20021 Jun 2002

    Activity: Participating in or organising an event typesParticipation in conference

    Scottish Society for Experimental Medicine

    David Newton (Participant)

    22 Nov 2002

    Activity: Participating in or organising an event typesParticipation in conference

    World Congress on Regional Anaesthesia

    David Newton (Participant)

    29 May 20021 Jun 2002

    Activity: Participating in or organising an event typesParticipation in conference

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