A nurse is assisting a physician who is preparing to suture a superficial laceration on a patient's leg. The physician asks the nurse to draw up lidocaine with epinephrine. The nurse understands that epinephrine is used with the lidocaine to:
a. allow more systemic absorption to speed up metabolism of the lidocaine.
b. increase the rate of absorption of the lido-caine.
c. improve perfusion by increasing blood flow to the area.
d. prolong anesthetic effects and reduce the risk of systemic toxicity from lidocaine.
D
Epinephrine causes vasoconstriction, which reduces local blood flow and delays systemic ab-sorption of lidocaine, which prolongs local anesthetic effects and reduces the risk of systemic toxicity. Epinephrine slows the rate of absorption. Epinephrine delays systemic absorption of li-docaine, so metabolism is slowed and the effects are prolonged in the periphery. Epinephrine does not increase local blood flow.
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