Abstract
Microvascular free tissue transfer has recently become a reliable procedure. However, hypoperfusion of the anastomotic site may occur due to vessel degeneration. In addition, vasospasm is a major problem during microvascular procedures that can contribute to ultimate failure of tissue transfer and replantation. Maintenance of sufficient blood flow and prevention and treatment of vasospasm are important in reconstructive surgery. Topical lidocaine has been widely used to treat vasospasm in microvascular surgery. The aim of this study was to evaluate the effect of topical application of 2% lidocaine in a rat experimental model. Using a laser Doppler flowmeter, the effect of lidocaine on the superficial epigastric artery of 35 male Sprague-Dawley rats was evaluated. In the first study, the change in blood flow following topical application of 2% lidocaine was investigated. Blood flow was measured for 15 minutes after topical application of saline (0.2 ml: Group I), saline (1.0 ml/hr: Group II), 2% lidocaine (0.2 ml: Group III), and 2% lidocaine (1.0 ml/hr: Group IV). In the second study, the effect of lidocaine on relief of vasospasm induced by application of 1:1000 epinephrine 0.03 ml was investigated. Blood flow was measured for 15 minutes after topical application of 1:1000 epinephrine (0.03 ml: Group V), 1:1000 epinephrine 0.03 ml + 2% lidocaine (0.2 ml: Group VI), and 1:1000 epinephrine + 2% lidocaine(1.0 ml/hr: Group VII). Topical application of 2% lidocaine increased blood flow of the rat superficial epigastric artery and relieved epinephrine-induced vasospasm. This method may be useful for improving the survival rate of microvascular free tissue transfer.
