What is the recommended maximum volume of epinephrine injection for hemostasis in endoscopic procedures?

The recommended maximum volume of epinephrine injection for hemostasis during endoscopic procedures is generally capped at 1cc, administered in smaller aliquots of 0.5-1cc. This approach is based on the need to minimize the risk of potential side effects associated with epinephrine, such as hypertension and tachycardia, particularly in sensitive patients or areas where precise control of hemostasis is critical.

Using smaller and more controlled doses allows for targeted hemostasis while reducing the risk of systemic absorption and associated complications. This technique is particularly important in delicate procedures where excessive vasoconstriction could lead to tissue ischemia or necrosis. Therefore, sticking to the guideline of 1cc total volume aids in maintaining patient safety and optimizing surgical outcomes.

While larger volumes are sometimes used in other medical contexts, they are not deemed safe or necessary in the endoscopic setting, where precise local control is often sufficient for achieving effective hemostasis.