What is the optimal concentration of epinephrine used to decrease the risk of toxicity?

The optimal concentration of epinephrine used to decrease the risk of toxicity is typically considered to be 1:200,000. This concentration strikes a balance between providing adequate vasoconstrictive effects, which help prolong the action of local anesthetics, and minimizing the potential for systemic toxicity associated with epinephrine. When concentrations are too high, the likelihood of systemic absorption increases, which can lead to adverse cardiovascular effects, including increased heart rate and blood pressure, as well as potential arrhythmias.

1:200,000 is widely accepted in many clinical settings as a safe and effective dilution that allows for improved control of bleeding while reducing the risk of potential side effects. This concentration offers a compromise between efficacy and safety, making it a preferred choice among healthcare practitioners when utilizing epinephrine as an adjunct in local anesthesia.