Local Shots with Epinephrine Under General Anethesia. Do You Really Need the Epinephrine for Eye and Nose Work?

Great question.  It is first very important to understand that the eyelids and especially the nose are incredibly vascular structures.  It is fairly standard to use some form of local anesthesia (lidocaine) in conjunction with a dilute for of epinephrine in order to minimize pain (which minimizes need for intravenous sedation and pain control agents) and bleeding.  Epinephrine constricts blood vessels and thereby helps minimize blood loss, improve operative visualization, and minimize local swelling.  All of these factors help ensure greater consistency in results and less downtime.

The epinephrine in the local shots is very important because the epinephrine causes a restriction of blood vessels in the local area so that the procedure can be performed without extensive bleeding.  Injections in the head and neck without epinephrine will result in numbness with excess bleeding.  The epinephrine is used for both numbness and excess bleeding.  The epinephrine also extends the length of the numbing medication as well.

Yes, the epinephrine in the solution constricts the blood vessels in the areas that are being treated.  If the epinephrine was not in the solution, your surgery would likely be a bloody mess and you would have significant post op bruising.  Areas of the face, especially the eyes and the nose, have very strong blood supply.  So epinephrine is essential.  

 

Good Luck.