Topic Adrenaline in post circumcision bleeding
Date First Published:
February 25, 2020
Last Updated:
February 1, 2021
Report by:
Alannah Madden, Clinical Fellow ED (MRI)
Search checked by:
Peter Hulme, MRI
Three-Part Question:
In [patients with post-circumcion bleeding] does [topical adrenaline] [reduce bleeding]
Clinical Scenario:
A 4 year old boy attended the paediatric 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 adrenaline in the management of these patients.
Is there any evidence behind the use of topical adrenaline in the management of these patients.
Search Strategy:
Using databases : CINAHL, EMBASE, Medline - last 10 years.
(topical adrenaline OR epinephrine).ti,ab
(post circumcision*
bleed*).ti,ab
(topical adrenaline OR epinephrine).ti,ab
(post circumcision*
bleed*).ti,ab
Search Details:
#tDatabasetSearch termtResults
1tCINAHLt(topical AND (adrenaline OR topical epinephrine)).ti,abt103
2tCINAHLtEPINEPHRINE/t4600
3tCINAHLt(1 OR 2)t4648
4tCINAHLt(adrenaline OR epinephrine).ti,abt4895
5tCINAHLt(3 OR 4)t7043
6tCINAHLt(post circumcision* bleed*).ti,abt10
7tCINAHLtCIRCUMCISION/t1847
8tCINAHLt(CIRCUMCIS*).ti,abt1977
9tCINAHLt(6 OR 7 OR 8)t2431
10tCINAHLt(5 AND 9)t3
11tEMBASEt(topical AND (adrenaline OR topical epinephrine)).ti,abt385
12tEMBASEtEPINEPHRINE/t11985
13tEMBASEt(adrenaline OR epinephrine).ti,abt60783
14tEMBASEt(11 OR 12 OR 13)t66227
15tEMBASEt(post circumcision* bleed*).ti,abt35
16tEMBASEtCIRCUMCISION/t8644
17tEMBASEt(CIRCUMCIS*).ti,abt8083
18tEMBASEt(15 OR 16 OR 17)t10281
19tEMBASEt(14 AND 18)t47
20tEMBASEt19 [DT 2009-2020]t20
21tMedlinet(topical AND (adrenaline OR topical epinephrine)).ti,abt639
22tMedlinetEPINEPHRINE/t54504
23tMedlinet(adrenaline OR epinephrine).ti,abt51998
24tMedlinet(21 OR 22 OR 23)t76447
25tMedlinet(post circumcision* bleed*).ti,abt47
26tMedlinet"CIRCUMCISION, FEMALE"/t1304
27tMedlinet"CIRCUMCISION, MALE"/t5079
28tMedlinet(CIRCUMCIS*).ti,abt6369
29tMedlinet(25 OR 26 OR 27 OR 28)t8388
30tMedlinet(24 AND 29)t35
31tMedlinet30 [DT 2009-2020]t8
1tCINAHLt(topical AND (adrenaline OR topical epinephrine)).ti,abt103
2tCINAHLtEPINEPHRINE/t4600
3tCINAHLt(1 OR 2)t4648
4tCINAHLt(adrenaline OR epinephrine).ti,abt4895
5tCINAHLt(3 OR 4)t7043
6tCINAHLt(post circumcision* bleed*).ti,abt10
7tCINAHLtCIRCUMCISION/t1847
8tCINAHLt(CIRCUMCIS*).ti,abt1977
9tCINAHLt(6 OR 7 OR 8)t2431
10tCINAHLt(5 AND 9)t3
11tEMBASEt(topical AND (adrenaline OR topical epinephrine)).ti,abt385
12tEMBASEtEPINEPHRINE/t11985
13tEMBASEt(adrenaline OR epinephrine).ti,abt60783
14tEMBASEt(11 OR 12 OR 13)t66227
15tEMBASEt(post circumcision* bleed*).ti,abt35
16tEMBASEtCIRCUMCISION/t8644
17tEMBASEt(CIRCUMCIS*).ti,abt8083
18tEMBASEt(15 OR 16 OR 17)t10281
19tEMBASEt(14 AND 18)t47
20tEMBASEt19 [DT 2009-2020]t20
21tMedlinet(topical AND (adrenaline OR topical epinephrine)).ti,abt639
22tMedlinetEPINEPHRINE/t54504
23tMedlinet(adrenaline OR epinephrine).ti,abt51998
24tMedlinet(21 OR 22 OR 23)t76447
25tMedlinet(post circumcision* bleed*).ti,abt47
26tMedlinet"CIRCUMCISION, FEMALE"/t1304
27tMedlinet"CIRCUMCISION, MALE"/t5079
28tMedlinet(CIRCUMCIS*).ti,abt6369
29tMedlinet(25 OR 26 OR 27 OR 28)t8388
30tMedlinet(24 AND 29)t35
31tMedlinet30 [DT 2009-2020]t8
Outcome:
No evidence for the use of topical adrenaline in bleeding post circumcision
Author Commentary:
There is no conclusive evidence currently published about the use of topical adrenaline in bleeding post circumcision.
Bottom Line:
There is nothing published to date about the use of topical adrenaline in post circumcision bleeds, therefore it is not possible to conclude whether it is effective for this purpose.