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    JENIFER KARINA PUTZ LORENZI
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    This document summarizes a best evidence topic report on the use of topical epinephrine in postcircumcision bleeding. A search of several databases found no evidence on the topic. There are currently no published studies conclusively showing whether topical epinephrine is effective in reducing postcircumcision bleeding. The authors declare no competing interests or external funding.

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    This document summarizes a best evidence topic report on the use of topical epinephrine in postcircumcision bleeding. A search of several databases found no evidence on the topic. There are currently no published studies conclusively showing whether topical epinephrine is effective in reducing postcircumcision bleeding. The authors declare no competing interests or external funding.

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    6 views1 page

    Bet 1

    Uploaded by

    JENIFER KARINA PUTZ LORENZI
    This document summarizes a best evidence topic report on the use of topical epinephrine in postcircumcision bleeding. A search of several databases found no evidence on the topic. There are currently no published studies conclusively showing whether topical epinephrine is effective in reducing postcircumcision bleeding. The authors declare no competing interests or external funding.

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    © All Rights Reserved
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    of 1

    Best Evidence Topic reports

    BET 1: Topical epinephrine in


    postcircumcision bleeding
    Authors: Alannah Madden, Peter Hulme
    Affiliation: Manchester Royal Infirmary, Manchester,
    UK

    Three-part question
    In patients with postcircumcision bleeding,
    does topical epinephrine reduce bleeding?

    Clinical scenario
    A 4-­ year-­
    old boy attended the paedi-
    atric emergency department following a
    circumcision for religious reasons earlier
    that day. He had ongoing bleeding from
    the surgical site.
    Is there any evidence behind the use of
    topical epinephrine in the management of
    these patients?

    Search strategy ­
    Using databases : CINAHL, EMBASE,
    MEDLINE—last 10 years.
    (topical epinephrine OR ​epinephrine).​
    ti,​ab 12. EMBASE EPINEPHRINE/ 11985 Search outcome
    (post circumcision* bleed*).ti,ab 13. EMBASE (epinephrine OR​ No evidence for the use of topical epineph-
    # Database search term results epinephrine).​ti,​ab 60  783 rine in postcircumcision bleeding
    1. CINAHL (topical AND (epinephrine 14. EMBASE (11 OR 12 OR 13) 66227
    OR topical ​epinephrine)).​ti,​ab 103 15. EMBASE (post circumcision*
    2. CINAHL EPINEPHRINE/ 4600 bleed*).ti,ab 35 Comment
    3. CINAHL (1 OR 2) 4648 16. EMBASE CIRCUMCISION/ 8644 There is no conclusive evidence currently
    4. CINAHL (epinephrine OR ​epineph- 17. EMBASE (CIRCUMCIS*).ti,ab 8083 published about the use of topical epineph-
    rine).​ti,​ab 4895 18. EMBASE (15 OR 16 OR 17) 10281 rine in postcircumcision bleeding.
    5. CINAHL (3 OR 4) 7043 19. EMBASE (14 AND 18) 47
    20. EMBASE 19 [DT 2009-2020] 20 Funding  The authors have not declared a specific
    6. CINAHL (post circumcision* bleed*).
    ti,ab 10 21. Medline (topical AND (epinephrine grant for this research from any funding agency in the
    public, commercial or not-­for-­profit sectors.
    7. CINAHL CIRCUMCISION/ 1847 OR topical ​epinephrine)).​ti,​ab 639
    22. Medline EPINEPHRINE/ 54 504 Competing interests  None declared.
    8. CINAHL (CIRCUMCIS*).ti,ab 1977
    9. CINAHL (6 OR 7 OR 8) 2431 23. Medline (epinephrine OR​ Patient consent for publication  Not required.
    10. CINAHL (5 AND 9) 3 epinephrine).​ti,​ab 51  998 Provenance and peer review  Not commissioned;
    11. EMBASE (topical AND (epinephrine 24. Medline (21 OR 22 OR 23) 76 447 internally peer reviewed.
    OR topical ​epinephrine)).​ti,​ab 385 25. Medline (post circumcision* bleed*). © Author(s) (or their employer(s)) 2021. No commercial
    ti,ab 47 re-­use. See rights and permissions. Published by BMJ.
    26. Medline “CIRCUMCISION, Emerg Med J 2021;38:322.
    Clinical bottom line FEMALE”/ 1304 doi:10.1136/emermed-2021-211306.2
    27. Medline “CIRCUMCISION,
    MALE”/ 5079
    There is nothing published to date
    28. Medline (CIRCUMCIS*).ti,ab 6369
    about the use of topical epinephrine in
    29. Medline (25 OR 26 OR 27 OR 28)
    postcircumcision bleeds, therefore it is
    8388
    not possible to conclude whether it is
    30. Medline (24 AND 29) 35
    effective for this purpose.
    31. Medline 30 [DT 2009–2020] 8
    322    Emerg Med J April 2021 Vol 38 No 4

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