Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original Article With Video IllustrationEpinephrine Diluted Saline–Irrigation Fluid in Arthroscopic Shoulder Surgery: A Significant Improvement of Clarity of Visual Field and Shortening of Total Operation Time. A Randomized Controlled Trial
Section snippets
Methods
After prospective power analysis and obtaining institutional review board approval, we performed a prospective randomized double-blind controlled trial to determine the influence of the addition of epinephrine to saline-irrigation fluid in therapeutic shoulder arthroscopy procedures on the visual clarity.
Patients were randomized into 2 groups: a control group and an epinephrine group. In the epinephrine group, the arthroscopy was performed with 0.33 mg of epinephrine diluted per liter of saline
Results
The data of 101 patients were analyzed. There was no difference seen in distribution between the epinephrine and the control groups concerning the subdivision into the different surgical subgroups (Fig 1). The distribution of the procedures performed in the epinephrine and the control group is shown in Table 1.
Discussion
Our study found significant improvement in visual clarity when epinephrine was added to saline-irrigation fluid during all types of therapeutic shoulder arthroscopies. The subacromial and RCR procedures did not benefit more than the intra-articular procedures. The TOT, total use of irrigation-fluid, and necessity of increasing the pressure-controlled-pump settings were reduced in the procedures performed in this study. No differences in preoperative measured vital parameters and had no
Conclusions
The addition of epinephrine (0.33 mg/L) to irrigation fluid significantly improves visual clarity in the most common types of therapeutic shoulder arthroscopy. A significant reduction in TOT and volume and use of irrigation fluid was observed. The greatest effect on visual clarity and shortening of operation time was seen in the Bankart and SLAP group. Therefore, one of our initial hypotheses that the greatest effect would be observed in the subacromial and RCR procedures was not supported by
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See commentary on page 445
The authors declare that they have no conflicts of interest in the authorship and publication of this article.