cherylkanepper

Anyone know how to screen a patient for undesireable reaction to epinephrine
administration? It would be given to me along with local anesthetic for minor
surgery. I know about the hypertension and I do have borderline hypertension
and whitecoat hypertension. I would also take oral valium prior to surgery.
Thanks for any answers.

dr. andrew b. chung, md/phd

Why not simply ask to *not* receive the epinephrine since you are concerned about
it?

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com

stephen nagler

................

Maybe because the epinephrine decreases bleeding and prolongs the
effect of the local?

Cheryl, the amount of epinephrine in a local anestheitic is
negligible. Unless large amounts of anesthetic are used or unless the
anesthetic is inadverently injected into a vein, there should be no
systemic effect whatsoever. Discuss your concerns with your doctor.
There are pros and cons for the use of epinephrine in a local.
Generally the pros outweigh the cons - but do have that discussion ...
and together you can decide what's in your best interest.

You know, my definition of "major" surgery is *any* surgery that is
done on me! :-)

I know you are concerned with your upcoming procedure - however minor
- and I do wish you well with it. In fact I can say with complete
confidence that everybody here does too! Everybody.

smn

freespiritedfem

I agree that any surgery done on me is major. LOL ! The incidents I've heard
about from epinephrine (and all I've heard is alleged) were from bad
reactions to normal administrations. However, I realize many medical mistakes
are covered up or simply never recognized. I'm wondering what non-invasive
tests could be conducted to relatively rule out the chances of having an
incident from epinephrine. Thank you for your answer.

freespiritedfem

The particular doctor I need to do the procedure must use it along with the
local. The only other option I may have is general anesthesia, which I refuse
for any cosmetic procedure. This procedure is little more than a skin cut.

dr. andrew b. chung, md/phd

For such a small amount, it is unlikely you will feel something untoward with the
small amount of epinephrine mixed with the local anesthetic. This epinephrine is
useful for local vasoconstriction which should allow the local anesthetic to hang
around longer.

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com

freespiritedfem

Andrew, thanks for your anxiety-allaying answer. One more question though:
could you tell me what would be the minimum and maximum amount of epi to be put
into the local, considering being enough to control bleeding and little enough
to be safe. I read something about a safe amount being .018 to .038mg. Also


each (one on each side of the head, naturally), with very little undermining.
I read it's 6 to 8 sutures required (for each cut, I assume) Thanks again so
much! Sherry

dr. andrew b. chung, md/phd

You are welcome.

Usual concentration is 1 mg per 1000 mls.


The actual amount will depend on the volume of the local anesthetic administered.

You are probably going to get about 0.015 mg of epi (15 mls of local anesthetic).

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/

stephen nagler

...............

Usual concentration is 5 mg per 1000 mls. ..................


..................

You are probably going to get about 0.075 mg of epi (15 mls of local anesthetic. .....................

.......................

Accurately,

smn

freespiritedfem

Andrew, thanks again. I will check this against what the cosmetic surgeon
tells me. Hopefully there won't be too much of a difference. Sherry