J Reconstr Microsurg 2021; 37(06): 541-550
DOI: 10.1055/s-0040-1722759
Original Article

Wire Myography for Continuous Estimation of the Optimal Concentration of Topical Lidocaine as a Vasodilator in Microsurgery

Haruo Ogawa
1  Department of Plastic Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan
,
Junya Kusumoto
2  Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan
,
Tadashi Nomura
1  Department of Plastic Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan
,
Kazunobu Hashikawa
1  Department of Plastic Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan
,
Hiroto Terashi
1  Department of Plastic Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan
,
Shunsuke Sakakibara
1  Department of Plastic Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan
› Author Affiliations
Funding This work was supported by JSPS KAKENHI (grant number JP 12850582).

Abstract

Background Intraoperative vasospasm during reconstructive microvascular surgery is often unpredictable and may lead to devastating flap loss. Therefore, various vasodilators are used in reconstructive microsurgery to prevent and relieve vasospasm. Lidocaine is a vasodilator commonly used in microvascular surgery. Although many reports have described its in vitro and in vivo concentration-dependent vasodilatory effects, limited studies have examined the pharmacological effects of lidocaine on blood vessels in terms of persistence and titer.

Methods In this study, the vasodilatory effect of lidocaine was examined by using the wire myograph system. Abdominal aortas were harvested from female rats, sliced into rings of 1-mm thickness, and mounted in the wire myograph system. Next, 10, 5, 2, and 1% lidocaine solutions were applied to the artery, and the change in vasodilation force, persistence of the force, and time required to reach equilibrium were measured.

Results The vasodilatory effect was confirmed in all groups following lidocaine treatment. Although strong vasodilation was observed in the 10% lidocaine group, it was accompanied by irreversible degeneration of the artery. Vasodilation in the 1% lidocaine group was weaker than that in the other groups 500 seconds after lidocaine addition (p < 0.05). Between the 5 and 2% lidocaine groups, 5% lidocaine showed a stronger vasodilatory effect 400 to 600 seconds after lidocaine addition (p < 0.01); however, there was no significant difference in these groups after 700 seconds. Additionally, there was no difference in the time required for the relaxation force to reach equilibrium among the 5, 2, and 1% lidocaine groups.

Conclusion Although our study confirmed the dose-dependent vasodilatory effect of lidocaine, 5% lidocaine showed the best vasodilatory effect and continuity with minimal irreversible changes in the arterial tissue.

Supplementary Material



Publication History

Received: 12 August 2020

Accepted: 19 November 2020

Publication Date:
31 January 2021 (online)

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