The effect of epidural anaesthesia on the reverse-flow fasciocutaneous flap: an experimental study in rabbits.
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.


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).


CONCLUSIONS
EA improves blood flow to RFFF and prevents the progression of venous congestion.
Uygur
Fatih
F
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
Sen
Hüseyin
H
Noyan
Nurettin
N
Sahin
Cihan
C
D000767:Anesthesia, Epidural / Q000379:methods*; D000779:Anesthetics, Local / Q000494:pharmacology; D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D002045:Bupivacaine / Q000494:pharmacology; D004195:Disease Models, Animal; D017078:Laser-Doppler Flowmetry / Q000379:methods; D008833:Microcirculation / Q000187:drug effects; D011817:Rabbits; D012867:Skin / Q000098:blood supply*; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply*
D000779:Anesthetics, Local; D002045:Bupivacaine