| Anesthesia for free vascularized tissue transfer. | |
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MedLine Citation:
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PMID: 18946883 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Anesthesia may be an important factor in maximizing the success of microsurgery by controlling the hemodynamics and the regional blood flow. The intraanesthetic basic goal is to maintain an optimal blood flow for the vascularized free flap by: increasing the circulatory blood flow, maintaining a normal body temperature to avoid peripheral vasoconstriction, reducing vasoconstriction resulted from pain, anxiety, hyperventilation, or some drugs, treating hypotension caused by extensive sympathetic block and low cardiac output. A hyperdynamic circulation can be obtained by hypervolemic or normovolemic hemodilution and by decrease of systemic vascular resistance. The importance of proper volume replacement has been widely accepted, but the optimal strategy is still open to debate. General anesthesia combined with various types of regional anesthesia is largely preferred for microvascular surgery. Maintenance of homeostasis through avoidance of hyperoxia, hypocapnia, and hypovolemia (all factors that can decrease cardiac output and induce local vasoconstriction) is a well-established perioperative goal. As the ischemia-reperfusion injury could occur, inhalatory anesthetics as sevoflurane (that attenuate the consequences of this process) seem to be the anesthetics of choice. |
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Authors:
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Natalia Hagau; Dan Longrois |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Microsurgery Volume: 29 ISSN: 1098-2752 ISO Abbreviation: Microsurgery Publication Date: 2009 |
Date Detail:
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Created Date: 2009-02-09 Completed Date: 2009-06-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8309230 Medline TA: Microsurgery Country: United States |
Other Details:
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Languages: eng Pagination: 161-7 Citation Subset: IM |
Copyright Information:
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(c) 2008 Wiley-Liss, Inc. |
Affiliation:
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Department of Anesthesia and Intensive Care, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania. hagaunatalia@gmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anesthesia* Anesthesia, Conduction Anesthetics, Inhalation Hematocrit Hemodilution Hemodynamics Homeostasis Humans Methyl Ethers Regional Blood Flow Reperfusion Injury / prevention & control Surgical Flaps* / blood supply Vascular Resistance |
| Chemical | |
Reg. No./Substance:
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0/Anesthetics, Inhalation; 0/Methyl Ethers; 28523-86-6/sevoflurane |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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