For a tummy tuck is it better to use Marcaine alone or Marcaine with adrenaline?

Question

For a tummy tuck and breast augmentation. What is the difference between the two?

Kenneth Hughes, MD · Answer

The vasoconstrictive effect from the epinephrine will help prolong the effect of action of the Marcaine.

Nidia H. De Jesus, MD, PhD · Answer

Marcaine (bupivacaine) is an anesthetic that is often used alone or in combination with adrenaline (epinephrine) to produce local/regional anesthesia. Epinephrine is a vasoconstrictor. Combined use allows the use of a greater concentration of bupivacaine and may also reduce blood loss during a surgical procedure.  Whether or not bupivacaine is used alone or in combination with epinephrine for a tummy tuck and breast augmentation is surgeon preference.

Camille Cash, MD · Answer

Typically marcaine is used with added epinephrine.  The epinephrine will act to constrict blood vessels which can increase the effectiveness of the marcaine. Unless there are circumstances present where the epinephrine is not recommended, it is often used.

Gary L. Ross, MBChB, FRCS · Answer

Adrenaline is a vaso constrictor and you can place more Marcaine in if it is combined with adrenaline. I prefer using adrenaline with local anaesthetic but occasionally there are circumstances where one cannot use adrenaline. Most PS would add adrenaline to anaesthetic. Best to ask your question to your PS.

Jeffrey Thaxton, MD FACS · Answer

The epi will prolong the anesthetic effect some for longer post op pain control and cause vasoconstriction which will likely reduce blood loss.  On the other hand using epi can in theory, with some evidence to back up the theory, increase the risk of infection and post op hematoma however both of these risks are small whether epi is used or not.  The bottom line is there is not a clear answer to which is better but either way you will likely do just fine whether epi is used or not as long as you have a qualified surgeon.

Paul Buhrer, MD (retired) · Answer

I typically use marcaine with epinephrine on abdominoplasty skin incisions and Exparel on the surface of the abdominal wall muscles. I prefer marcaine with epinephrine because the epinephrine constricts blood vessels minimizing the blood loss associated with the skin incisions and it has the ability to prolong the anesthetic effect into the postoperative period. Exparel may provide an anesthetic effect on the muscles minimizing pain in this area for up to 96 hours.

For a tummy tuck is it better to use Marcaine alone or Marcaine with adrenaline?

Answers (6)

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