Epinephrine in the tumescent technique for hypospadia surgery
The use of tumescent technique, which contains epinephrine, in penile surgery has not been reported previously. Two patients with hypospadias had reconstructive operation using tumescent technique with a "One-per-Mil" tumescent solution containing epinephrine intra-operatively. The results was a clear operation field, almost bloodless during dissection, and no complication on the penis after epinephrine injection with minimal edema. Apparently, the "One-per-Mil" tumescent solution acts as a natural hydro-dissector creating avascular anatomic tissue planes for easier and more rapid dissection in surgery for hypospadias. We suggest that epinephrine is safe to be injected in penis as a future area of clinical practice. (Med J Indones. 2012;21:175-8)
Giannantoni A. Hypospadias classification and repair: the riddle of the sphinx. Eur Urol. 2011;60:1190-2.
Mustoe TA, Lalonde DH. The safe management of anesthesia, sedation, and pain in plastic surgery. Plast Reconstr Surg. 2010;126(4):165e-76e.
Atabey AM, Galdino G, El-shahat A, Ramirez OM. Effects of tumescent solutions containing lidocaine and epinephrine on skin flap survival in rats. Ann Plast Surg. 2004;53(1):70-2.
Muck AE, Bebarta VS, Borys DJ, Morgan DL. Six years of epinephrine digital injections: absence of significant local or systemic effects. Ann Emerg Med. 2010;56(3):270-4.
Singer AJ. Accidental digital self-injection of epinephrine: debunking the myth. Ann Emerg Med. 2010;56(3):275-7.
Ghali S, Knox KR, Verbesey J, Scarpidis U, Izadi K, Ganchi PA. Effects of lidocaine and epinephrine on cutaneous blood flow. J Plast Reconstr Aesth Surg. 2008;61:1226-31.
Abbott AM, Miller BT, Tuttle TM. Outcomes after tumescence technique versus electrocautery mastectomy. Ann Surg Oncol. 2012;10:2304-8.
Klein J. Tumescent technique for liposuction surgery. Am J Cosmet Surg. 1987;4:263-7.9. Lapid O. Syringe-delivered tumescent anesthesia made easier. Aesth Plast Surg. 2011;35:601-2.
Copyright (c) 2012 Theddeus O.H. Prasetyono, Nandita M. Putri
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with Medical Journal of Indonesia agree to the following terms:
- Authors retain copyright and grant Medical Journal of Indonesia right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial License that allows others to remix, adapt, build upon the work non-commercially with an acknowledgment of the work’s authorship and initial publication in Medical Journal of Indonesia.
- Authors are permitted to copy and redistribute the journal's published version of the work non-commercially (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Medical Journal of Indonesia.