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Vasoconstrictors in Facial Plastic Surgery
Donna J. Millay, MD;
Wayne F. Larrabee, Jr, MD;
Randall L. Carpenter, MD
Arch Otolaryngol Head Neck Surg. 1991;117(2):160-163.
Abstract
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• The effectiveness of local anesthetics is improved by the addition of a vasoconstrictor with an increased duration of action and the ability to decrease both systemic toxic reactions and local bleeding. Epinephrine, the standard drug for vasoconstriction, has some limitations due to potential cardiac and local toxic effects. Using an animal model, we compared the effects of various concentrations of epinephrine and two other vasoconstrictors, phenylephrine hydrochloride and felypressin, on local blood flow. We also examined the local effects of bupivacaine hydrochloride and ropivacaine hydrochloride, a new local anesthetic. We found that felypressin was as effective a vasoconstrictor as epinephrine, with fewer potential toxic reactions. Phenylephrine (Neo-Synephrine), on the other hand, was less effective, with a shorter duration of action. As expected, bupivacaine produced vasodilation, while ropivacaine was found to have vasoconstrictive properties.
(Arch Otolaryngol Head Neck Surg. 1991;117:160-163)
Author Affiliations
From the Section of Otolaryngology, University of Vermont, Burlington (Dr Millay); the Department of Otolaryngology, University of Washington (Dr Larrabee); and the Department of Anesthesia, Virginia Mason Clinic, Seattle, Wash (Dr Carpenter).
Footnotes
Accepted for publication September 4, 1990.
Read before the Fifth International Facial Plastic Surgery Symposium, Toronto, Ontario, June 27, 1989.
Reprint requests to 1 S Prospect St, Burlington, VT 05401 (Dr Millay).
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