Use of Midodrine for Intraoperative Hemostasis in Cutaneous and Percutaneous Surgery

The gold standard formulations for local anesthesia contain epinephrine at a concentration of 1:100,000 to aid in hemostasis. Epinephrine contains off-target effects that carry risk of adverse events from injections with these injections.

Further, the ongoing global shortage of epinephrine highlights the need for a safer and viable alternative. Midodrine, an a1-adrenergic receptor agonist, is utilized as a vasopressor to induce arterial and venous vasoconstriction. We developed a novel formulation of 2% lidocaine combined with 1:2,000,000 epinephrine and 50uM midodrine.