The Hemodynamic Effect of the Local Epinephrine Injection to a Burn Scar

Kwak, In Suk; Park, Jae Young; Bae, Ji Young; Woo, Chul Ho; Kim, Kwang Min

Abstract

BACKGROUND: As a method for reducing bleeding, epinephrine local infiltration is used in hypertrophic scar release. However, this can induce unexpected increased absorption and increase the cardiovascular risk. Therefore we evaluated the hemodynamic effects of epinephrine local infiltration.
METHODS
Sixty patients underwent hypertropic scar release under general anesthesia. Thirty patients who do not have a history of hypertension were classified as group 1, and thirty patients who had a history of hypertension were classified as group 2. The heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were observed before injection of epinephrine and every minute up to six minutes after injection of epinephrine.
RESULTS
Even though the HR significantly increased at 1 and 2 minutes in each group, the difference between the two groups was not significant. The SBP, DBP and MAP were significantly increased in group 2 compared to group 1. The SBP of group 2 significantly increased at every minute up to six minutes and group 1 had a significant increased for 2 minutes. The DBP of group 2 significantly increased for 3 minutes and group 1 significantly increased for 2 minutes. The MAP of group 2 significantly increased for 2 minutes and group 1 significantly increased for 2 minutes (P < 0.05).
CONCLUSIONS
Local infiltration of epinephrine in hypertrophic scar temporarily increases the heart rate and blood pressure. Therefore, the patient with hypertension can have an increased the cardiovascular risk and this should be carefully considered.