Arthroscopic shoulder surgery with epinephrine saline irrigation

Purpose: To determine whether dilute epinephrine saline irrigation (0.33 mg /L) delivered by a pressure-controlled pump would significantly reduce intr aoperative bleeding during routine arthroscopic shoulder surgery and, in ad dition, to investigate potential adverse cardiovascular reactions of adding epinephrine to the irrigation fluid. Type of Study: Prospective, randomize d, double-blinded, placebo-controlled study. Methods: Fifty-four patients r equiring arthroscopic shoulder surgery were randomly assigned to either an epinephrine group that received dilute epinephrine irrigation by a pressure -controlled pump or to a placebo group that received plain saline irrigatio n by a pressure-controlled pump. Intraoperative. intra-articular bleeding w as estimated by multiplying the total volume of the irrigation fluid used w ith the hemoglobin concentration in the irrigation fluid. Postoperatively, the surgeon rated the clarity of the visual field during the arthroscopy by a visual analogy scale. Results: Intraoperative bleeding was significantly reduced (P =.008) and the clarity of the visual field was significantly be tter (P =.0007) in the group of patients receiving dilute epinephrine irrig ation compared with the group of patients without epinephrine added to the irrigation fluid. Conclusions: The addition of epinephrine to irrigation fl uid seems to reduce intra-articular bleeding during routine arthroscopic sh oulder surgery and may improve visualization. Furthermore. no cardiovascula r adverse reactions were observed resulting from the intra-articular epinep hrine administration.