Effects of sympthomimetric drugs on free flaps in head and neck surgery

Patient Population
Head & neck free flap reconstruction.

LiDCO Monitor
LiDCOrapid.

Trial Design
Prospective comparison of blood flow in free flap versus control tissue in 24 patients.

Outcome Impact
Norepinephrine most consistently elevated the mean arterial pressure and caused by far the largest increase in flap skin blood flow, making it the pressor agent of choice (of those studied), following free tissue transfer.

 

PURPOSE
This study sought

MATERIALS AND METHODS
24 patients undergoing free flap surgery for head and neck cancer resection with a standard planned post-operative ICU admission.

RESULTS
Dose-dependenr, increased free flap skin blood flow was observed with norepinephrine and dobutamine. Both dopamine and epinephrine infusions decreased blood flow.

CONCLUSIONS
“Both dobutamine and norepinephrine had beneficial effects on flap skin flow. The maximal improvement in flow occurred with norepinephrine, making it the optimal pressor to use in patients with hypotension after free flap surgery .”

Eley KA, Young JD, Watt-Smith SR. Epinephrine, Norepinephrine, Dobutamine, and Dopexamine Effects on Free Flap Skin Blood Flow. Plast Reconstr Surg. 2012;130(3):564-70.

“Norepinephrine most consistently elevated the mean arterial pressure and caused by far the largest increase in flap skin blood flow, making it the pressor agent of choice (of those studied), following free tissue transfer.”

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