Local anesthetic with vasoconstrictor

A local anesthetic with vasoconstrictor is a combination drug of a local anesthetic in order to induce absence of pain in an area, given with a vasoconstrictor in order to increase the duration of local anesthesia by constricting the blood vessels, thereby safely concentrating the anesthetic agent for an extended duration, as well as reducing hemorrhage.^[1]

Examples

• Prilocaine/epinephrine (trade name Citanest Forte)
• Iontocaine, consisting of lidocaine and epinephrine
• Septocaine (trade name Septodont), a combination of articaine and epinephrine

Contraindications

Local anesthetics with vasoconstrictors should not be used in the nose, fingers, toes and penis, because the arteries here are end arteries, so the vasoconstrictor effect could cause ischemia and even gangrene of the affected part.^[2] Rather, a local anesthetic without vasoconstrictor should be used for local anesthesia in such parts.

References

1. ^ Yagiela JA (1995). "Vasoconstrictor agents for local anesthesia". Anesth Prog 42 (3-4): 116–20. PMC 2148913. PMID 8934977. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2148913. 
2. ^ Page 292 in: O'Brien, Denise; Burden, Nancy; Quinn, Donna M. DeFazio (2000). Ambulatory surgical nursing. Philadelphia: W.B. Saunders. ISBN 0-7216-6847-X.