Why the study?
Does infiltration of lidocaine with epinephrine cause skin necrosis in susceptible patients undergoing ambulatory phlebectomy?
Does infiltration of lidocaine with epinephrine cause skin necrosis in susceptible patients undergoing ambulatory phlebectomy?
Epinephrine in local anesthetics may cause full-thickness skin necrosis in susceptible patients undergoing ambulatory phlebectomy.
Answers are grounded in this paper and cite their sources.
May warrant epinephrine avoidance in phlebectomy; hypothesis-generating for rare necrosis risk and needs controlled confirmation.
BACKGROUND: Full-thickness skin necrosis can occur after infiltration of 1.0% lidocaine with 1/100,000 epinephrine for ambulatory phlebectomy. OBJECTIVE: To demonstrate an exaggerated local response to epinephrine resulting in full-thickness skin necrosis and ultimately a permanent scar. METHODS: A postoperative complication was clinically observed. CONCLUSION: Permanent scar formation after ambulatory phlebectomy was found in a patient with a previous probable exaggerated local response to epinephrine. Uneventful phlebectomy resulted in the same patient when epinephrine was deleted from the local anesthetic, suggesting a local inability to eliminate epinephrine or an exaggerated local alpha-one response.
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Jose Antonio Olivencia (1996) studied this question.
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