The effect of epidural anesthesia on the arterial maximum velocity of free flap in lower extremity microvascular reconstruction

One of the key factors for free flap survival is maintaining adequate perfusion
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This was a prospective randomized study in which patients were assigned to receive combined general epidural anesthesia (epidural group, n=26) or general anesthesia alone (control group, n=26)
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Figure 1 Source of the article

After epidural injection of 10ml of surfactant ropivacaine, the researchers used ultrasound technology to analyze the effect of ropivacaine on the arterial maximum velocity of free flaps
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Figure 2 Schematic diagram of the time and sequence of microscopic free flap surgery in patients with lower extremity reconstruction

The results showed that the maximum arterial flow velocity in the epidural group was significantly higher than that in the epidural group 30 minutes after the experimental procedure was started (35.

Figure 3 Comparison of maximum arterial flow velocity 30 minutes after baseline measurement between control and epidural groups

Pain scores at 1 hour postoperatively and opioid requirements at 1 and 6 hours postoperatively were significantly lower in the epidural group than in the epidural group [3.

There were no significant differences in intraoperative hemodynamics or other postoperative outcomes between the two groups

Epidural anesthesia increases the arterial maximum flow rate of the free flap and reduces postoperative pain and need for opioids

These results suggest that epidural anesthesia may have an effective effect on flap pedicle arterial blood flow and postoperative pain, and that maintaining adequate flap perfusion is a good option in microscopic free flap surgery for lower extremity reconstruction select

Original article:

Park Jun-Young,Suh Hyunsuk Peter,Kwon Jin Geun et al.