Local anesthetics that have epinephrine (also known as adrenaline) added to them are commonly referred to as "epinephrine-containing local anesthetics" or "epinephrine-admixed local anesthetics." The addition of epinephrine to the local anesthetic solution serves to constrict blood vessels at the injection site, which helps reduce bleeding, prolongs the anesthetic effect, and decreases systemic absorption of the anesthetic, thus minimizing the risk of toxicity.
While epinephrine-containing local anesthetics are commonly used in adults, they are generally avoided or used with caution in infants and young children due to the potential risks associated with epinephrine in this age group. Some reasons for avoiding epinephrine-containing local anesthetics in children include:
Risk of systemic effects: Infants and young children may be more sensitive to the systemic effects of epinephrine, such as increased heart rate, elevated blood pressure, and potential adverse reactions.
Smaller size and dose considerations: The small size of infants and young children requires precise dosing, and the use of epinephrine-containing local anesthetics may complicate dosing calculations.
Avoidance of vasoconstriction: Epinephrine's vasoconstrictive properties could pose a risk in certain situations, particularly in areas with limited blood flow or highly vascularized tissues.
Limited research in children: There may be limited safety data on the use of epinephrine-containing local anesthetics in infants and young children, which can lead to caution in their use.
Instead of using epinephrine-containing local anesthetics, healthcare providers often opt for plain or non-epinephrine local anesthetics for procedures in infants and young children. These types of local anesthetics provide effective pain relief without the vasoconstrictive effects of epinephrine.
It's essential for healthcare professionals to carefully consider the specific needs and risks for each individual patient, and to use appropriate local anesthetics based on the age, medical history, and other relevant factors of the child undergoing the procedure. As with any medical intervention, the decision to use local anesthesia in children should be made by a qualified healthcare provider based on a thorough evaluation of the child's health and medical requirements.