The use of gingival retraction cord impregnated with epinephrine should be avoided in patients at all levels of cardiac risk due to the rapid absorption of a high concentration of the epinephrine and the resulting potential for adverse cardiovascular effects.

Ephinephrine Impregnated Retraction Cord

Introduction

Alternatives

Plain cord, when saturated with one of the following alternatives to epinephrine provide gingival effects equivalent to those of epinephrine without adverse cardiovascular effects:

Tetrahydrozoline Hcl 0.05% (Visine)
Oxymetazoline HCl 0.05% (Afrin)

References

Dental Management of the Medically Compromised Patient. Little, Falace, Miller, Rhodus. 8th Edition