Ventricular standstill: a complication of intrapleural anesthesia using bupivacaine in a patient with free transverse rectus abdominus myocutaneous flap breast reconstruction.

Transverse rectus abdominus myocutaneous (TRAM) flap is one of the commonly used techniques for breast reconstruction. Postoperative pain relief is of paramount importance following TRAM flap breast reconstruction to avoid potentially preventable complications like chest infection. Several methods of pain control are available, including intrapleural anesthesia.