Lidocaine with Epinephrine Is Safe for Hand Surgery

In a single-center retrospective study involving more than 1000 consecutive patients undergoing hand surgery, the use of epinephrine in digital blocks did not increase the risk for vascular compromise in the hand or digits. Compared with the 500 patients who received digital blocks with just lidocaine (dose range, 2 cc–10 cc; average, 5.7 cc), the 611 who had blocks with lidocaine plus epinephrine (1:100,000; average dosage, 4.33 cc) were no more likely to suffer from digital gangrene, nerve injury, or unusually delayed wound healing. In fact, no gangrene occurred in the epinephrine group.