Elective Epinephrine Use in the Fingers and Hand: The Dalhousie Project Clinical Phase

Methods: From 2002 to 2004 there were 9 hand surgeons in 6 cities who prospectively recorded each consecutive case of elective hand and finger epinephrine injection. They recorded each instance of skin or tissue loss and the number of times phentolamine reversal of adrenaline vasoconstriction was required. Results: There were 3,110 consecutive cases of elective injection of low-dose epinephrine (1: 100,000 or less) in the hand and fingers and none produced any instance of digital tissue loss. Phentolamine was not required to reverse the vasoconstriction in any patients. Conclusions: The true incidence of finger infarction in elective low-dose epinephrine injection into the