The use of epinephrin in surgery depends on its local effect as a vasoconstrictor, and, after absorption, on its effects on the heart and circulation in general.
When epinephrin comes in contact with a limited area of the peripheral circulation as a result of local absorption or of injection into the tissues, it acts promptly as a vasoconstrictor. The action persists over a considerable but variable period of time, depending chiefly on the concentration of the drug, and the activity of the circulation through the area affected. Clinically, this action may be counted on for about one hour; in strong concentration it may act considerably longer up to several hours. Constriction may be followed by vasodilation.
In surgery, local vasoconstriction may be produced by injection into the tissues directly, or by application to mucous, serous or wound surfaces. The action is not purely local; the possibility of a constitutional effect
RICHARDSON EP. GLANDULAR THERAPY: THE SURGICAL APPLICATION OF EPINEPHRIN. JAMA. 1924;83(20):1587–1588. doi:10.1001/jama.1924.26610200002012
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