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Revisiting Epinephrine in Foot Surgery

Philip Radovic, DPM^*,, Robert G. Smith, DPM, RPh, CPed and Don Shumway, DPM^*

^* Aestheticare Outpatient Surgery Center, San Juan Capistrano, CA.
Private practice, San Clemente, CA.
Private practice, Edgewater, FL.

Corresponding author: Don Shumway, DPM, Aestheticare Outpatient Surgery Center, 30260 Rancho Viejo Rd, San Juan Capistrano, CA 92675.

Abstract

Anesthetics containing epinephrine have long been thought unsuitable for use in the foot and, particularly, the digits. However, research suggests that epinephrine use is beneficial in the appropriately selected patient. These benefits include a decreased local anesthetic plasma concentration; an increased duration of anesthesia, with a decreased need for additional narcotic use after surgery; decreased development of hemorrhage and postoperative hematoma, without occlusion of vessels; and a lack of complications (in millions of patients reported on in the literature). A retrospective review of more than 150 patients receiving local anesthetics containing epinephrine revealed no complications in the foot and ankle. (J Am Podiatr Med Assoc 93(2): 157-160, 2003)

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