Mechanism of Epinephrine Enhancement of Lidocaine-induced Skeletal Muscle Necrosis

Abstract
Skeletal muscle damage produced in rats by 2% lidocaine in combination with agents that mimic or modify actions of epinephrine was assessed histologically. Only drugs producing vasoconstriction- epinephrine, phenylephrine, and felypressin — significantly augmented lidocaine myotoxicity. This potentiation was in direct relation to each drug's ability to retard absorption of the local anesthetic from its injection site.