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Maximal haemostatic effect is attained in porcine skin within 7 minutes of the administration of a local anaesthetic together with epinephrine, refuting the need for a 30-minute waiting time

Sheikh, Rafi LU ; Hult, Jenny LU ; Bunke, Josefine LU ; Dahlstrand, Ulf LU ; Ansson, Cu LU ; Memarzadeh, Khashayar LU and Malmsjö, Malin LU (2019) In JPRAS Open 19. p.77-81
Abstract
Objective

Based on clinical experience gained over many years, the maximal haemostatic effect following administration of local anaesthetics containing epinephrine is generally believed to occur within 10 minutes. Surprisingly, it was found in a recent study, in which bleeding was quantified intraoperatively, that maximal haemostasis did not occur until 30 minutes. If this is indeed the case, then it would be necessary to extend the preoperative waiting time to minimize perioperative bleeding.

We have carried out a carefully controlled study on the time delay between administration of a local anaesthetic containing epinephrine and maximal haemostasis in a surgical setting.
Methods

Lidocaine 20 mg/ml (2 %) or... (More)
Objective

Based on clinical experience gained over many years, the maximal haemostatic effect following administration of local anaesthetics containing epinephrine is generally believed to occur within 10 minutes. Surprisingly, it was found in a recent study, in which bleeding was quantified intraoperatively, that maximal haemostasis did not occur until 30 minutes. If this is indeed the case, then it would be necessary to extend the preoperative waiting time to minimize perioperative bleeding.

We have carried out a carefully controlled study on the time delay between administration of a local anaesthetic containing epinephrine and maximal haemostasis in a surgical setting.
Methods

Lidocaine 20 mg/ml (2 %) or lidocaine + epinephrine 12.5 µg/ml (1:80 000) was injected into the skin of eight pig flanks. Bleeding was induced after 3, 5, 7, 15 and 30 minutes by making a 10 mm incision at each injection site. Blood was collected for 1 minute and weighed.
Results

A gradual reduction in bleeding was observed, with maximal reduction after only 7 minutes (54 %, p<0.05, 95% CI: 44 - 64%). No further significant reduction in bleeding was observed (62% at 15 and 66% at 30 min, p = n.s. compared to 7 min).
Conclusions

Maximal haemostatic effect in the current setting was observed within 7 minutes of injection of lidocaine with epinephrine. This is in good agreement with previous empirical findings, and we see no reason to prolong the preoperative waiting time. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
JPRAS Open
volume
19
pages
77 - 81
publisher
Elsevier Ltd
external identifiers
  • scopus:85059743452
ISSN
2352-5878
DOI
10.1016/j.jpra.2018.12.005
language
English
LU publication?
yes
id
06ce3789-691c-45cb-9745-391776adc443
date added to LUP
2018-12-27 00:33:09
date last changed
2019-01-27 05:33:16
@article{06ce3789-691c-45cb-9745-391776adc443,
  abstract     = {Objective<br>
<br>
Based on clinical experience gained over many years, the maximal haemostatic effect following administration of local anaesthetics containing epinephrine is generally believed to occur within 10 minutes. Surprisingly, it was found in a recent study, in which bleeding was quantified intraoperatively, that maximal haemostasis did not occur until 30 minutes. If this is indeed the case, then it would be necessary to extend the preoperative waiting time to minimize perioperative bleeding.<br>
<br>
We have carried out a carefully controlled study on the time delay between administration of a local anaesthetic containing epinephrine and maximal haemostasis in a surgical setting.<br>
Methods<br>
<br>
Lidocaine 20 mg/ml (2 %) or lidocaine + epinephrine 12.5 µg/ml (1:80 000) was injected into the skin of eight pig flanks. Bleeding was induced after 3, 5, 7, 15 and 30 minutes by making a 10 mm incision at each injection site. Blood was collected for 1 minute and weighed.<br>
Results<br>
<br>
A gradual reduction in bleeding was observed, with maximal reduction after only 7 minutes (54 %, p&lt;0.05, 95% CI: 44 - 64%). No further significant reduction in bleeding was observed (62% at 15 and 66% at 30 min, p = n.s. compared to 7 min).<br>
Conclusions<br>
<br>
Maximal haemostatic effect in the current setting was observed within 7 minutes of injection of lidocaine with epinephrine. This is in good agreement with previous empirical findings, and we see no reason to prolong the preoperative waiting time.},
  author       = {Sheikh, Rafi and Hult, Jenny and Bunke, Josefine and Dahlstrand, Ulf and Ansson, Cu and Memarzadeh, Khashayar and Malmsjö, Malin},
  issn         = {2352-5878},
  language     = {eng},
  pages        = {77--81},
  publisher    = {Elsevier Ltd},
  series       = {JPRAS Open},
  title        = {Maximal haemostatic effect is attained in porcine skin within 7 minutes of the administration of a local anaesthetic together with epinephrine, refuting the need for a 30-minute waiting time},
  url          = {http://dx.doi.org/10.1016/j.jpra.2018.12.005},
  volume       = {19},
  year         = {2019},
}