Cargando…

Incidence of the “Adrenaline Rush” and Vasovagal Response with Local Anesthetic Injection

BACKGROUND: Many patients feel an “adrenaline rush” or a vasovagal reaction when injected with lidocaine and epinephrine during wide awake surgery. The incidence of these reactions is not well documented in the literature. METHODS: In total, 387 patients were prospectively injected with lidocaine an...

Descripción completa

Detalles Bibliográficos
Autores principales: Greene, Bradley H. C., Lalonde, Donald H., Seal, Shane K. F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8225362/
https://www.ncbi.nlm.nih.gov/pubmed/34178562
http://dx.doi.org/10.1097/GOX.0000000000003659
_version_ 1783712073774006272
author Greene, Bradley H. C.
Lalonde, Donald H.
Seal, Shane K. F.
author_facet Greene, Bradley H. C.
Lalonde, Donald H.
Seal, Shane K. F.
author_sort Greene, Bradley H. C.
collection PubMed
description BACKGROUND: Many patients feel an “adrenaline rush” or a vasovagal reaction when injected with lidocaine and epinephrine during wide awake surgery. The incidence of these reactions is not well documented in the literature. METHODS: In total, 387 patients were prospectively injected with lidocaine and epinephrine for minor procedures without sedation between July 1, 2019 and November 1, 2020. A concentration of epinephrine with 1:100,000 in 2% lidocaine was injected, with most patients getting less than 20 mL of volume. RESULTS: Eight (2.2%) of the patients had adrenaline rush symptoms, which included nervousness, anxiety, tremors, shaky feelings, flushing, diaphoresis, light-headedness, tingling, and “heart racing.” Seven patients (1.8%) experienced vasovagal responses, which included nausea, a feeling of being unwell, faint, or lightheaded, or had circumoral pallor. CONCLUSIONS: Patients run a low risk of feeling an adrenaline rush or vasovagal reaction when injected with lidocaine and epinephrine. Routinely advising patients that the adrenaline rush can happen, and that this is not an allergic reaction can be helpful to allay fear of the unknown and to prevent false allergy beliefs. Injecting patients lying down may decrease the incidence of vasovagal reactions by increasing cerebral blood flow with the advantage of gravity.
format Online
Article
Text
id pubmed-8225362
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-82253622021-06-25 Incidence of the “Adrenaline Rush” and Vasovagal Response with Local Anesthetic Injection Greene, Bradley H. C. Lalonde, Donald H. Seal, Shane K. F. Plast Reconstr Surg Glob Open Hand/Peripheral Nerve BACKGROUND: Many patients feel an “adrenaline rush” or a vasovagal reaction when injected with lidocaine and epinephrine during wide awake surgery. The incidence of these reactions is not well documented in the literature. METHODS: In total, 387 patients were prospectively injected with lidocaine and epinephrine for minor procedures without sedation between July 1, 2019 and November 1, 2020. A concentration of epinephrine with 1:100,000 in 2% lidocaine was injected, with most patients getting less than 20 mL of volume. RESULTS: Eight (2.2%) of the patients had adrenaline rush symptoms, which included nervousness, anxiety, tremors, shaky feelings, flushing, diaphoresis, light-headedness, tingling, and “heart racing.” Seven patients (1.8%) experienced vasovagal responses, which included nausea, a feeling of being unwell, faint, or lightheaded, or had circumoral pallor. CONCLUSIONS: Patients run a low risk of feeling an adrenaline rush or vasovagal reaction when injected with lidocaine and epinephrine. Routinely advising patients that the adrenaline rush can happen, and that this is not an allergic reaction can be helpful to allay fear of the unknown and to prevent false allergy beliefs. Injecting patients lying down may decrease the incidence of vasovagal reactions by increasing cerebral blood flow with the advantage of gravity. Lippincott Williams & Wilkins 2021-06-24 /pmc/articles/PMC8225362/ /pubmed/34178562 http://dx.doi.org/10.1097/GOX.0000000000003659 Text en Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Hand/Peripheral Nerve
Greene, Bradley H. C.
Lalonde, Donald H.
Seal, Shane K. F.
Incidence of the “Adrenaline Rush” and Vasovagal Response with Local Anesthetic Injection
title Incidence of the “Adrenaline Rush” and Vasovagal Response with Local Anesthetic Injection
title_full Incidence of the “Adrenaline Rush” and Vasovagal Response with Local Anesthetic Injection
title_fullStr Incidence of the “Adrenaline Rush” and Vasovagal Response with Local Anesthetic Injection
title_full_unstemmed Incidence of the “Adrenaline Rush” and Vasovagal Response with Local Anesthetic Injection
title_short Incidence of the “Adrenaline Rush” and Vasovagal Response with Local Anesthetic Injection
title_sort incidence of the “adrenaline rush” and vasovagal response with local anesthetic injection
topic Hand/Peripheral Nerve
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8225362/
https://www.ncbi.nlm.nih.gov/pubmed/34178562
http://dx.doi.org/10.1097/GOX.0000000000003659
work_keys_str_mv AT greenebradleyhc incidenceoftheadrenalinerushandvasovagalresponsewithlocalanestheticinjection
AT lalondedonaldh incidenceoftheadrenalinerushandvasovagalresponsewithlocalanestheticinjection
AT sealshanekf incidenceoftheadrenalinerushandvasovagalresponsewithlocalanestheticinjection