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Arch Otolaryngol Head Neck Surg. 2001;127:1280.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Dr Ohlms has satisfied the editor's requirements in her article for "Clinical Challenges in Otolaryngology" and is to be commended for her review of a very practical subject. She has included a pertinent and current bibliography on this subject. Her review giving the "pros" and "cons" of the subject is concise yet thorough. The advantages of less intraoperative bleeding and possible ease of dissection are clearly supported, while the desired advantage of postoperative pain management does not seem to be supported. The complications referenced certainly encourage the surgeon to weigh the benefit-risk ratio closely..

Figure appears in full text version. William S. Gibson, Jr, MD

I have personally used local anesthetic with epinephrine for over 30 years without a complication. I use it in patients 10 years and older because it does decrease intraoperative bleeding. Less postoperative pain or greater bleeding has not been my experience to date.

My preference for anesthetic agent is 0.5% . . . [Full Text of this Article]

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