Division of Plastic Surgery, Department of Surgery, Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia; ICTEC (The Indonesian Clinical Training and Education Center), Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Department of Surgery, National Brain Center, Jakarta, Indonesia.
J Surg Res. 2019 Apr;236:166-171. doi: 10.1016/j.jss.2018.11.024. Epub 2018 Dec 17.
This study aimed to find out the optimal time delay of epinephrine in one-per-mil tumescent solution containing 1:1,000,000 epinephrine and 0.2% lidocaine to achieve optimal visualization in hand surgery.
Twelve healthy male subjects who volunteered to join this prospective, randomized, double blind study were selected with convenient sampling technique. The subject's hand and the solution, either the one-per-mil or normal saline solution, were randomly selected. Injections were given to the ring finger's pulp, whereas the oxygen saturation (SpO) of each finger was measured with Masimo's Radical-7 Pulse Oximeter at 5 min before injection and continuously up to 45 min after injection. The device showed the SpO every 2 s. Any value of SpO was noted if it stayed the same point for at least 30 s in a row without interruption. The time of the lowest SpO was recorded and analyzed.
The average of SpO after injection in the epinephrine group was 96.5 (95-97), P = 0.002, whereas the normal saline group was 97.5 ± 1.168, P = 0.003. Both were statistically significant compared with their respective baseline values. The average delta SpO of the epinephrine group was 3.42 ± 0.996, whereas the normal saline group was 1.50 ± 1.567 (P = 0.001; CI 0.923-2.911). The time to achieve the lowest SpO in the epinephrine group was obtained at the average time of 13.90 ± 5.38 min after injection.
The optimal time delay of the epinephrine in the one-per-mil tumescent solution was 13.90 ± 5.38 min after injection.
本研究旨在找出 1:100 万肾上腺素加入 0.2%利多卡因的 1%肿胀溶液中肾上腺素的最佳时间延迟，以实现手部手术的最佳可视化。
采用方便抽样法选择 12 名自愿参加这项前瞻性、随机、双盲研究的健康男性志愿者。随机选择受试者的手和溶液，分别为 1%溶液或生理盐水溶液。向环指指腹注射，同时使用 Masimo 的 Radical-7 脉搏血氧仪测量每个手指的血氧饱和度（SpO），在注射前 5 分钟开始测量，并持续测量至注射后 45 分钟。该设备每 2 秒显示一次 SpO。如果连续 30 秒内 SpO 值保持不变且无中断，将记录并分析任何 SpO 值。
肾上腺素组注射后 SpO 的平均值为 96.5（95-97），P=0.002，而生理盐水组为 97.5±1.168，P=0.003，与各自的基线值相比均有统计学意义。肾上腺素组的平均 SpO 差值为 3.42±0.996，而生理盐水组为 1.50±1.567（P=0.001；CI 0.923-2.911）。肾上腺素组达到最低 SpO 的时间平均为注射后 13.90±5.38 分钟。
1%肿胀溶液中肾上腺素的最佳注射时间延迟为 13.90±5.38 分钟。
