Drug question-epinephrine soaked sponge

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During shoulder surgery, sometimes orthopedic surgeons like an epinepherine soaked sponge that they place in the humeral canal. Anyone know what is the correct dosage-some just dip the whole sponge in 1:1000 20 ml, have not seen any adverse affects, but that seems awfully high to me. Anyone have an idea?

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Specializes in RETIRED Cath Lab/Cardiology/Radiology.

Moved to Operating Room Nursing forum.

Advise you check with your facility for protocol/procedure documentation (should be available in the OR).

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During shoulder surgery, sometimes orthopedic surgeons like an epinepherine soaked sponge that they place in the humeral canal. Anyone know what is the correct dosage-some just dip the whole sponge in 1:1000 20 ml, have not seen any adverse affects, but that seems awfully high to me. Anyone have an idea?

1:1000 is one mg/ml epinepherine. A fully soaked, unwrung sponge can hold up to 10 mls and if you stuff 10 mg of epinepherine into the bone you will get a big sympathetic response and an unhappy anesthesia provider. Is it really a 1:1000 solution? It's hard to imagine that there is no response and if it is, the sponges must not have very much at all on them as there doesn't seem to be much transfer at all. Or there might be an you're not seeing it because of whatever the anesthesia person is doing.

But it does sound like a typical ortho surgeon move to do something like that. If it isn't causing a problem, don't worry about it.

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