Document Detail


The effect of epidural anaesthesia on the reverse-flow fasciocutaneous flap: an experimental study in rabbits.
MedLine Citation:
PMID:  19501975     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The reverse-flow fasciocutaneous flap has been popularised as a feasible alternative to reconstruction of the post-burn contractures around lower-extremity joints. The effect of epidural anaesthesia (EA) on the haemodynamics of reverse-flow fasciocutaneous flap (RFFF) has not yet been investigated. Therefore, it was our primary objective to determine how EA impacts on vascular haemodynamics and tissue perfusion.
MATERIALS AND METHODS: This study included 30 New Zealand white rabbits. The reverse-flow saphenous fasciocutaneous island flap in rabbit model was used. In group I (n=10), epidural catheterisation of the rabbits were performed and they received an epidural infusion of 0.1 ml kg(-1) 0.125% bupivacaine 12-h periods until the 10th day. In group II (n=10), epidural catheterisation of the rabbits was performed and they received an epidural infusion of 0.1 ml kg(-1) isotonic sodium chloride solution. In group III (n=10), epidural catheterisation of the rabbits was not performed. Intra-arterial blood pressure (IABP) and intravenous blood pressure (IVBP) was recorded at time intervals of 5, 15, 30 and 60 min, respectively, after tourniquet release on the first and 10th day. Microcirculatory flow was measured by laser Doppler flowmetry at 2, 4, 6, 8 and 10 days in all the groups.
RESULTS: Throughout the experiment, the flaps showed complete survival. A significant difference was noted in the microcirculatory flow measurements in the flap surfaces between group I and groups II-III throughout the experiment (p<0.05). A significant difference was noted in IVBP and IABP between group I and groups II-III (p<0.05). On the first and the 10th day, however, there were no significant differences between groups II and III (p>0.05).
CONCLUSION: EA improves blood flow to RFFF and prevents the progression of venous congestion.
Authors:
Fatih Uygur; Hüseyin Sen; Nurettin Noyan; Cihan Sahin
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Publication Detail:
Type:  Journal Article     Date:  2009-06-06
Journal Detail:
Title:  Burns : journal of the International Society for Burn Injuries     Volume:  36     ISSN:  1879-1409     ISO Abbreviation:  Burns     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-17     Completed Date:  2010-09-16     Revised Date:  2011-01-11    
Medline Journal Info:
Nlm Unique ID:  8913178     Medline TA:  Burns     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  270-6     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2009 Elsevier Ltd and ISBI. All rights reserved.
Affiliation:
Department of Plastic and Reconstructive Surgery and Burn Unit, Gülhane Military Medical Academy and Medical Faculty, Haydarpaşa Training Hospital, Selimiye Mahallesi Tibbiye Caddesi, Usküdar, Istanbul, Turkey. fatihuygur@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Anesthesia, Epidural / methods*
Anesthetics, Local / pharmacology
Animals
Blood Pressure / drug effects
Bupivacaine / pharmacology
Disease Models, Animal
Laser-Doppler Flowmetry / methods
Microcirculation / drug effects
Rabbits
Skin / blood supply*
Skin Transplantation / methods
Surgical Flaps / blood supply*
Chemical
Reg. No./Substance:
0/Anesthetics, Local; 2180-92-9/Bupivacaine
Comments/Corrections
Comment In:
Burns. 2011 Feb;37(1):174-5; author reply 175   [PMID:  21050665 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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