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A combination of a local anesthetic (commonly lidocaine or bupivacaine) and epinephrine is used to induce local or regional anesthesia for surgical, dental, diagnostic, therapeutic, or obstetrical procedures. The local anesthetic blocks sodium channels in nerve membranes to prevent the initiation and conduction of nerve impulses (causing numbness), while the addition of epinephrine—a potent alpha- and beta-adrenergic agonist—induces vasoconstriction at the site of administration. This vasoconstriction reduces systemic absorption of the anesthetic (prolonging its effect), decreases bleeding in the operative field, allows for higher doses by reducing toxicity risk, and extends duration of anesthesia[1][2][5][6]. This combination is widely used in clinical practice.
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