Treating Vasospasm at Microsurgical Anastomosis

What is it about?

Microsurgical breast reconstruction may be compromised by vasospasm either during, or after surgery, which may lead to flap loss. Papaverine is commonly used to treat vasospasm during surgery; however, a shortage of Papaverine meant it was necessary to explore the use of other drugs. We reviewed outcomes after microsurgical breast reconstruction with two other antispasmodics, Lidocaine and Nicardipine.

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Why is it important?

Intra-operative vasospasm is potentially devastating as it may lead to loss of the reconstructed breast, but it may be treated with Papaverine. Our results showed that there was no increase in partial or total flap loss, return to the operating room or flap necrosis with alternate antispasmodics. We demonstrate that it is safe to use Lidocaine or Nicardipine as a substitute for Papaverine during microsurgical breast reconstruction.