Physicians’ Desk Reference, 53rd Ed, pp 636, 916, 1017, Medical Economics Co, Montvale, NJ, 1999..
Skidmore RA, Patterson JD, Tomsick RS: Local anesthetics. .Dermatol Surg 22::511. ,1996. .
Steinberg MD, Block P: The use and abuse of epinephrine in local anesthetics. .JAPA 61::341. ,1971. .
Green D, Walter J, Heden R, et al: The effects of local anesthetics containing epinephrine on digital blood perfusion. .JAPMA 82::88. ,1992. .
Roth RD: Utilization of epinephrine-containing anesthetic solutions in the toes. .JAPA 71::189. ,1981. .
Marcaine [package insert], Sterling Winthrop Inc, New York, 1999..
Kaplan EG, Kashuk K: Disclaiming the myth of use of epinephrine local anesthesia in feet. .JAPA 61::335. ,1971. .
Gosteli P, Van Gessel E, Gamulin Z: Effects of pH adjustment and carbonation of lidocaine during epidural anesthesia for foot or ankle surgery. .Anesth Analg 81::104. ,1995. .
Burm AG, Vankleef JW, Gladines MP, et al: Epidural anesthesia with lidocaine and bupivacaine: effects of epinephrine on the plasma concentration profiles. .Anesth Analg 65::1281. ,1986. .
Todd K, Berk WA, Huang R: Effect of body locale and addition of epinephrine on the duration of action of a local anesthetic agent. .Ann Emerg Med 21::723. ,1992. .
Scarlet JJ, Walter JH Jr, Bachmann RJ: Digital blood perfusion following injections of plain lidocaine and lidocaine with epinephrine. .JAPA 68::339. ,1978. .
Singelyn FJ, Aye F, Gouverneur JM: Continuous popliteal sciatic nerve block: an original technique to provide postoperative analgesia after foot surgery. .Anesth Analg 84::383. ,1997. .
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)