title: Is additional epidural sympathetic block in microvascular surgery contraindicated? A preliminary report.
abstract: The use of additional epidural sympathetic block during and after microvascular surgery in the lower extremities to prevent vasospasm is generally agreed on. However, a significant fall in the perfusion rate of the transplants was seen after application of bupivacaine (Marcain) via the epidural catheter. This effect has, to our knowledge, not been described before and is probably caused by the sympathectomy effect of this type of analgesia.
authors.affiliation: Nijmegen University Hospital St Radboud, St Maartens Clinic-Nijmegen, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: van Twisk
authors.forename: M J
authors.initials: MJ
authors.lastname: Gielen
authors.forename: P W
authors.initials: PW
authors.lastname: Pavlov
authors.forename: P H
authors.initials: PH
authors.lastname: Robinson
mesh_terms: D000767:Anesthesia, Epidural / Q000009:adverse effects*; D001340:Autonomic Nerve Block / Q000009:adverse effects*; D002045:Bupivacaine / Q000009:adverse effects; D005360:Fibula / Q000637:transplantation; D006801:Humans; D008866:Microsurgery; D012039:Regional Blood Flow; D013524:Surgical Flaps; D014656:Vascular Surgical Procedures
chemical_list: D002045:Bupivacaine