Digital Necrosis After Lidocaine and Epinephrine Injection in the Flexor Tendon Sheath Without Phentolamine Rescue.
Digital Necrosis After Lidocaine and Epinephrine Injection in the Flexor Tendon Sheath Without Phentolamine Rescue.
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DOI：
10.1016/j.jhsa.2016.10.015
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发表时间：
2017-02-01
期刊：
影响因子：
--
通讯作者：
Carr, Nicholas
中科院分区：
文献类型：
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作者：
Zhang, Jacques X;Gray, Jason;Carr, Nicholas
文献一般支持肾上腺素注射的安全性，但最近的病例报告描述了与使用利多卡因和肾上腺素有关的缺血性不良事件，在这些事件中没有进行酚妥拉明抢救。我们报告一例患者，在手掌脂肪和屈肌鞘注射1%利多卡因和1：100,000肾上腺素后发生手指坏死和随后的截肢，以释放三指扳机。未进行酚妥拉明抢救。所有在手指使用肾上腺素的外科医生都应该准备好在指尖持续不足的情况下用酚妥拉明抢救来逆转血管收缩。
The literature generally supports the safety of epinephrine injection in the digits, but recent case reports describe ischemic adverse events associated with the use of lidocaine and epinephrine in which phentolamine rescue was not performed. We present a case of finger necrosis and subsequent amputation in a patient after 1% lidocaine with 1:100,000 epinephrine was injected in the fat and flexor sheaths in the palm for a 3-finger trigger release. Phentolamine rescue was not performed. All surgeons who use epinephrine in the finger should be prepared to reverse vasoconstriction with phentolamine rescue if there is persistently inadequate perfusion of the fingertip.