Efficacy of ethyl nitrite in reversing surgical vasospasm.
Vasospasm leading to thrombosis is a major cause of free flap failure. Flap blood flow may improve by application of vasodilating agents to the pedicle. The purpose of this study is to evaluate the effect of a novel S-nitrosylating agent, O-ethyl nitrite, on flap blood flow and pedicle vessels diameter in a rat model, after induction of vasospasm. Two hours after surgery, the arterial diameter was significantly (P < .05) dilated by treatment with O-ethyl nitrite, lidocaine, or lidocaine + O-ethyl nitrite. None of these treatments had a statistically significant effect on blood flow or venous diameter. Twenty-four hours following surgery, both O-ethyl nitrite- and lidocaine-treated groups had larger arteries than the control group (P < .05). The O-ethyl nitrite-treated animals also had significantly (P < .05) elevated blood flow compared with control animals, but lidocaine-treated animals did not demonstrate any improved flow at 24 hours. O-Ethyl nitrite may become clinically useful in microvascular surgery procedures.
Baccarani
Alessio
A
Division of Plastic, Reconstructive, Maxillofacial, and Oral Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
Yasui
Koji
K
Olbrich
Kevin C
KC
El-Sabbagh
Ahmed
A
Kovach
Stephen
S
Follmar
Keith E
KE
Erdmann
Detlev
D
Levin
L Scott
LS
Stamler
Jonathan S
JS
Klitzman
Bruce
B
Zenn
Michael R
MR
D000818:Animals; D017078:Laser-Doppler Flowmetry; D008297:Male; D009573:Nitrites / Q000494:pharmacology* / Q000627:therapeutic use; D011355:Prodrugs / Q000494:pharmacology* / Q000627:therapeutic use*; D051381:Rats; D011919:Rats, Inbred Strains; D012039:Regional Blood Flow / Q000187:drug effects; D014652:Vascular Diseases / Q000188:drug therapy; D014661:Vasoconstriction / Q000187:drug effects; D014665:Vasodilator Agents / Q000494:pharmacology* / Q000627:therapeutic use
D009573:Nitrites; D011355:Prodrugs; D014665:Vasodilator Agents; C032712:ethyl nitrite