van Rijt W G Geert, de Wildt Ramon P, Tellier Michiel A
Isala klinieken, afd. Plastische, reconstructieve en handchirurgie, Zwolle.
Ned Tijdschr Geneeskd. 2014;158:A7390.
In the Netherlands there is no consensus regarding the addition of epinephrine (adrenaline) to local anaesthetics for use in the fingers. This is based on the persistent belief that the addition of epinephrine to local anaesthetics for use in the fingers is contraindicated due to the risk of ischaemic complications. Ischaemic complications arising from the use of modern anaesthetics containing epinephrine have, however, never been described. The addition of epinephrine results in a reduced arterial blood-flow and has several benefits, such as reduced blood loss and extended duration of anaesthesia. Local anaesthesia containing epinephrine enables relatively extensive surgical procedures to be carried out on the extremities without the customary use of a tourniquet. Preoperative threat of reduced circulation in the fingers is a contraindication for the use of local anaesthetics with added epinephrine.
在荷兰，对于在手指局部麻醉中添加肾上腺素（ adrenaline ）尚无共识。这是基于一种长期存在的观念，即由于存在缺血性并发症的风险，在手指局部麻醉中添加肾上腺素是禁忌的。然而，使用含肾上腺素的现代麻醉剂引发缺血性并发症的情况从未被描述过。添加肾上腺素会导致动脉血流减少，但有诸多益处，如减少失血和延长麻醉持续时间。含肾上腺素的局部麻醉能够在不常规使用止血带的情况下，在四肢进行相对广泛的外科手术。手指术前存在循环减少的风险是使用添加肾上腺素的局部麻醉剂的禁忌证。
