The use of lidocaine with adrenaline reduces blood loss and operating time in free TRAM breast reconstruction

Abstract.

Free transverse abdominis myocutaneous flap (TRAM) reconstruction is regarded as a major operation involving significant blood loss and a long operating time. Infiltration of a local anaesthetic with adrenaline has been used to reduce blood loss in reduction mammoplasty with good results. In this study, 80–100 ml 0.5% lidocaine with adrenaline (1:100,000) was infiltrated preoperatively in 13 TRAM reconstruction patients (study group). Infiltration was subcutaneous to the lower abdomen, the mastectomy scar and the other breast (if operated on). In the control group (15 patients), there was no such infiltration. The groups were similar to each other in patient and oncological characteristics. Perioperative blood loss was significantly lower in the study group (382 ml) than in the control group (987 ml). The operating time was also significantly shorter in the study group (142 min) than in the control group (188 min). There were no systemic side effects of lidocaine or adrenaline, nor where there were any flap losses, skin necroses or wound infections calling for revision in either group.