{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:11:28Z","timestamp":1792098688810,"version":"4.4.0"},"reference-count":10,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,11,6]],"date-time":"2014-11-06T00:00:00Z","timestamp":1415232000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,11,6]],"date-time":"2014-11-06T00:00:00Z","timestamp":1415232000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2014,11,6]],"date-time":"2014-11-06T00:00:00Z","timestamp":1415232000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["arthroscopyjournal.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The objective of the current study was to compare surgeon\u2010rated visualization in shoulder arthroscopy using irrigation fluid with and without epinephrine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eighty\u2010three patients were randomized to receive irrigation fluid with (44 patients) or without (39 patients) epinephrine during their arthroscopic shoulder procedures. After each procedure, the blinded senior author (G.F.C.) evaluated visualization based on a visual analog scale (VAS), and all clinically important procedure variables were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighty\u2010three arthroscopic shoulder procedures were included in the study. Fifty\u2010four of these procedures were arthroscopic rotator cuff repairs, allowing a subset analysis of this specific procedure. There was a significant difference, with improved visualization in the epinephrine group versus the group without epinephrine when comparing all procedures (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .0001) and when comparing only rotator cuff repairs (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a0.0001). However, there was no statistical difference in other clinically important variables, including operative time and amount of irrigation fluid used.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The addition of epinephrine to irrigation fluid significantly improves surgeon\u2010rated visualization in shoulder arthroscopy. Without an observed significant difference in operative time or volume of irrigation fluid used, the clinical significance of this improved visualization is unclear, and the use of irrigation fluid without epinephrine remains a viable option in the hands of an experienced surgeon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level I, high\u2010quality randomized controlled trial with statistically significant difference.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2014.08.010","type":"journal-article","created":{"date-parts":[[2014,11,6]],"date-time":"2014-11-06T13:40:53Z","timestamp":1415281253000},"page":"12-18","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":53,"title":["Surgeon\u2010Rated Visualization in Shoulder Arthroscopy: A\u00a0Randomized Blinded Controlled Trial Comparing Irrigation Fluid With and Without Epinephrine"],"prefix":"10.1002","volume":"31","author":[{"suffix":"III","given":"Daniel M.","family":"Avery","sequence":"first","affiliation":[{"name":"St. Luke's Orthopaedic Specialists St. Luke's University Hospital Bethlehem PA U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett W.","family":"Gibson","sequence":"additional","affiliation":[{"name":"St. Luke's Orthopaedic Specialists St. Luke's University Hospital Bethlehem PA U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory F.","family":"Carolan","sequence":"additional","affiliation":[{"name":"St. Luke's Orthopaedic Specialists St. Luke's University Hospital Bethlehem PA U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,11,6]]},"reference":[{"key":"e_1_2_2_2_2","doi-asserted-by":"publisher","DOI":"10.1053\/jars.2001.23590"},{"key":"e_1_2_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0749-8063(95)90137-X"},{"key":"e_1_2_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0749-8063(95)90131-0"},{"key":"e_1_2_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465990270031501"},{"key":"e_1_2_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2011.11.023"},{"key":"e_1_2_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2004.04.017"},{"key":"e_1_2_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2007.10.003"},{"key":"e_1_2_2_9_2","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20090818-32"},{"key":"e_1_2_2_10_2","first-page":"957","article-title":"Upper airway obstruction following arthroscopic rotator cuff repair due to excess irrigation fluid","volume":"38","author":"Jirativanont T.","year":"2010","journal-title":"Anaesth Intensive Care"},{"key":"e_1_2_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2011.02.027"}],"container-title":["Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806314007099?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806314007099?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2014.08.010","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.arthro.2014.08.010","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2014.08.010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T09:23:03Z","timestamp":1773566583000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.arthro.2014.08.010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,11,6]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2015,1]]}},"alternative-id":["10.1016\/j.arthro.2014.08.010"],"URL":"https:\/\/doi.org\/10.1016\/j.arthro.2014.08.010","archive":["Portico"],"relation":{},"ISSN":["0749-8063","1526-3231"],"issn-type":[{"value":"0749-8063","type":"print"},{"value":"1526-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,11,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Surgeon-Rated Visualization in Shoulder Arthroscopy: A\u00a0Randomized Blinded Controlled Trial Comparing Irrigation Fluid With and Without Epinephrine","name":"articletitle","label":"Article Title"},{"value":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.arthro.2014.08.010","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Copyright \u00a9 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}