Necrosis of the Right Hallux Secondary to Local Anesthesia by Lidocaine 2% with Adrenaline: A Rare and Preventable Complication
-
Jemea Bonaventure
,
Nga Nomo Serge
,
Iroume Cristella
,
Kuitchet Aristide
,
Djomo Tamchom Dominique
,
Binyom Pierre René
,
Nkoumou Samson
Abstract
Recent scientific studies support the safe use of lidocaïne with adrenaline for anesthesia of the extremities (fingers, toes, nose, ear, penis), these studies push back the myth that advises against the use of local anesthetic substances with adrenaline in these areas [1-3]. Ingrown toenail is a common condition of the big toe. Surgery is often necessary. Ingrown toenail surgery is relatively straightforward and is usually performed under local anesthesia [3]. We report here a rare case of hallux necrosis secondary to local anesthesia by lidocaine 2% with adrenaline. The objective of this presentation is to warn practitioners about the observance of precautions before using local anesthetics with adrenaline for anesthetic procedures of the extremities.
[1] Andrades PR, Olguin FA, Calderón W. Digital blocks with or without epinephrine. Plast Reconstr Surg. 2003; 111(5):1769-70.
[2] Zhang JX, Gray J, Lalonde DH, Carr N. Digital Necrosis After Lidocaine and Epinephrine Injection in the flexor tendon sheath without phentolamine rescue. J Hand Surg Am. 2017; 42(2):e119-e123.
[3] Nielsen LJ, Lumholt P, Hölmich LR. Local anaesthesia with vasoconstrictor is safe to use in areas with end-arteries in fingers, toes, noses and ears. Ugeskr Laeger. 2014; 176(44):V04140238.
[4] Finsen V. Necrosis in fingers and toes following local anaesthesia with adrenaline an urban legend. Tidsskr Nor Laegeforen. 2013; 133(17):1827-30.
[5] Nielsen LJ, Lumholt P, Hölmich LR. Local anaesthesia with vasoconstrictor is safe to use in areas with end-arteries in fingers, toes, noses and ears. Ugeskr Laeger. 2014; 176(44):V04140238.
[6] Denkler K. A comprehensive review of epinephrine in the finger: to do or not to do. Plast Reconstr Surg. 2001;108(1):114-24.
[7] Waterbrook AL, Germann CA, Southall JC. Is epinephrine harmful when used with anesthetics for digital nerve blocks? Ann Emerg Med. 2007;50(4):472-5.
[8] Ilicki J. Safety of Epinephrine in Digital Nerve Blocks: A Literature Review. J Emerg Med. 2015; 49(5):799-809.
[9] Prabhakar H, Rath S, Kalaivani M, Bhanderi N. Adrenaline with lidocaine for digital nerve blocks. Cochrane Database Syst Rev. 2015; 2015(3):CD010645.
[10] Dos Reis Júnior A, Quinto D. Digital block with or without the addition of epinephrine in the anesthetic solution. Braz J Anesthesiol. 2016; 66(1):63-71.
[11] Ruiter T, Harter T, Miladore N, Neafus A, Kasdan M. Finger amputation after injection with lidocaine and epinephrine. Eplasty. 2014; 14:ic43.
[12] Aycock BG, Hawtof DB, Moody SB. Treatment of peripheral ischemia secondary to lidocaine containing epinephrine. Ann Plast Surg. 1989;23(1):27-30.
[13] McNeil C, Copeland J. Accidental digital epinephrine injection: to treat or not to treat? Can Fam Physician. 2014; 60(8):726-8.
[14] Sylaidis P, Logan A. Digital blocks with adrenaline. An old dogma refuted. J Hand Surg Edinb Scotl. 1998; 23:17-9.
[15] Altinyazar HC, Ozdemir H, Koca R, Hoşnuter M, Demirel CB, Gündoğdu S. Epinephrine in digital block: color Doppler flow imaging. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2004; 30:508–11.
[16] Campard S, Gazeau T, Debec G, De Keating-HartWide E. Awake Local Anesthesia No Tourniquet (WALANT) échoguidé. Le praticien en anesthésie réanimation. 2020; 24(1):22-25.
[2] Zhang JX, Gray J, Lalonde DH, Carr N. Digital Necrosis After Lidocaine and Epinephrine Injection in the flexor tendon sheath without phentolamine rescue. J Hand Surg Am. 2017; 42(2):e119-e123.
[3] Nielsen LJ, Lumholt P, Hölmich LR. Local anaesthesia with vasoconstrictor is safe to use in areas with end-arteries in fingers, toes, noses and ears. Ugeskr Laeger. 2014; 176(44):V04140238.
[4] Finsen V. Necrosis in fingers and toes following local anaesthesia with adrenaline an urban legend. Tidsskr Nor Laegeforen. 2013; 133(17):1827-30.
[5] Nielsen LJ, Lumholt P, Hölmich LR. Local anaesthesia with vasoconstrictor is safe to use in areas with end-arteries in fingers, toes, noses and ears. Ugeskr Laeger. 2014; 176(44):V04140238.
[6] Denkler K. A comprehensive review of epinephrine in the finger: to do or not to do. Plast Reconstr Surg. 2001;108(1):114-24.
[7] Waterbrook AL, Germann CA, Southall JC. Is epinephrine harmful when used with anesthetics for digital nerve blocks? Ann Emerg Med. 2007;50(4):472-5.
[8] Ilicki J. Safety of Epinephrine in Digital Nerve Blocks: A Literature Review. J Emerg Med. 2015; 49(5):799-809.
[9] Prabhakar H, Rath S, Kalaivani M, Bhanderi N. Adrenaline with lidocaine for digital nerve blocks. Cochrane Database Syst Rev. 2015; 2015(3):CD010645.
[10] Dos Reis Júnior A, Quinto D. Digital block with or without the addition of epinephrine in the anesthetic solution. Braz J Anesthesiol. 2016; 66(1):63-71.
[11] Ruiter T, Harter T, Miladore N, Neafus A, Kasdan M. Finger amputation after injection with lidocaine and epinephrine. Eplasty. 2014; 14:ic43.
[12] Aycock BG, Hawtof DB, Moody SB. Treatment of peripheral ischemia secondary to lidocaine containing epinephrine. Ann Plast Surg. 1989;23(1):27-30.
[13] McNeil C, Copeland J. Accidental digital epinephrine injection: to treat or not to treat? Can Fam Physician. 2014; 60(8):726-8.
[14] Sylaidis P, Logan A. Digital blocks with adrenaline. An old dogma refuted. J Hand Surg Edinb Scotl. 1998; 23:17-9.
[15] Altinyazar HC, Ozdemir H, Koca R, Hoşnuter M, Demirel CB, Gündoğdu S. Epinephrine in digital block: color Doppler flow imaging. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2004; 30:508–11.
[16] Campard S, Gazeau T, Debec G, De Keating-HartWide E. Awake Local Anesthesia No Tourniquet (WALANT) échoguidé. Le praticien en anesthésie réanimation. 2020; 24(1):22-25.
| Files | ||
| Issue | Vol 8 No 4 (2022): Autumn |
|
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/aacc.v8i4.10186 | |
| Keywords | ||
| Necrosis of the right hallux Local anesthesia Adrenaline Preventable complication | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Bonaventure J, Serge NN, Cristella I, Aristide K, Dominique D, René B, Samson N. Necrosis of the Right Hallux Secondary to Local Anesthesia by Lidocaine 2% with Adrenaline: A Rare and Preventable Complication. Arch Anesth & Crit Care. 2022;8(4):339-342.
