Does Perioperative Use of Noradrenaline Affect Free Flap Outcome Following Reconstructive Microvascular Surgeries? A Retrospective Analysis

Autor:	Anish Mohan, Manu Sudevan, Sunil Rajan, Dilesh Kadapamannil, Lakshmi Kumar, Jerry Paul
Rok vydání:	2019
Předmět:	Reconstructive surgery medicine.medical_specialty business.industry Hemodynamics 030208 emergency & critical care medicine vasopressors Perioperative Free flap Tertiary care reconstructive surgery 03 medical and health sciences 0302 clinical medicine Blood pressure 030202 anesthesiology Anesthesia Materials Chemistry medicine Retrospective analysis noradrenaline vasoconstriction Original Article medicine.symptom business Vasoconstriction
Zdroj:	Anesthesia, Essays and Researches
ISSN:	0259-1162
Popis:	Background: Over concerns of vasoconstriction leading to free flap failure, it has been a common practice to avoid vasopressors for the maintenance of blood pressure during reconstructive microvascular surgeries. Aims: The aim of this study was to assess the impact of use of noradrenaline in the perioperative period on outcome of free flaps in patients who underwent reconstructive surgeries as compared to those who did not receive noradrenaline. Settings and Design: Retrospective analysis was conducted at a tertiary care institute. Materials and Methods: A total of 120 patients who underwent free flap surgeries were included in the study, of which 102 patients who did not require noradrenaline perioperatively formed the control group (Group C), whereas those who required noradrenaline infusion constituted the study group (Group N). Data regarding flap outcome at discharge, intraoperative hemodynamics and temperature were documented. Statistical Test Used: Chi-square test, Mann–Whitney test, Independent sample t -test, and paired t -test were used for statistical analysis. Results: Out of 120 patients, 15% ( n = 18) patients required noradrenaline (Group N). In Group N, 27.78% ( n = 5) patients and in Group C, 22.55% ( n = 23) were re-explored. Four patients in Group C and none in Group N had a poor flap outcome (3.92% vs. 0%). There was no significant difference in surgical duration and the volume of crystalloids received in both groups. Preoperative hemoglobin levels were lower in Group N; intraoperatively, they were more hypothermic and needed more colloids, blood, and plasma. Conclusion: Perioperative use of noradrenaline did not adversely affect free flap survival in patients who underwent microvascular reconstructive surgeries. Although re-exploration rate was marginally increased with use of noradrenaline, the final flap outcome was unaffected.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::58040619bc510ca3af521c0430faa429 https://pubmed.ncbi.nlm.nih.gov/31031485 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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