The optimal ratio of epinephrine and lidocaine in local surgery depends on the specific procedure, the location of injection, and patient factors. Here are the most commonly used concentrations:
Standard Ratios Used in Local Surgery
Lidocaine 1% or 2% with Epinephrine 1:100,000Most commonly used concentrationProvides vasoconstriction to minimize bleedingExtends the duration of anesthesiaUsed in areas with good collateral circulation (e.g., face, scalp, extremities)Lidocaine 1% or 2% with Epinephrine 1:200,000Provides slightly less vasoconstriction than 1:100,000 but still effectiveReduces the risk of systemic effects of epinephrineUsed when lower epinephrine doses are preferred
How the Ratio Works
1:100,000 = 10 mcg/ml epinephrine1:200,000 = 5 mcg/ml epinephrineHigher epinephrine concentration (e.g., 1:100,000) provides better hemostasis but may have a higher risk of systemic side effects.
Considerations for Use
Avoid epinephrine in end-artery areas (fingers, toes, nose, ear, penis) unless specifically indicated.Patients with cardiovascular conditions may be at higher risk for complications with epinephrine.Longer procedures may benefit from higher epinephrine concentrations to prolong anesthetic effect.
