Anesthesia and surgical microvascular flaps.
OBJECTIVE
Head and neck reconstructive surgery represents a major challenge facing the need to achieve a good cosmetic and functional outcome. Anesthesia may be an important and determining factor in the technique success due to its role in hemodynamic stability and regional blood flow. On the other hand, regional anesthesia, changes in blood volume, and vasoactive drugs may influence blood flow in the flap. Thus, due to the lack of recommendations based on evidence, the anesthetic technique of these procedures is most often inspired in pathophysiological considerations. The aim of this paper is to review relevant aspects regarding anesthetic practice in these cases.


BACKGROUND
Importance of the type of surgical flap, physiological considerations, and anesthetic approach.


CONCLUSIONS
In surgery with microvascular flaps, the anesthesiologist role includes optimizing the physiological conditions for the survival of the flap without increasing the non-surgical morbidity.
Anesthesiology, Hospital S. Teotônio, Viseu, Portugal.
Cláudia Margarida Brito
CM
Pereira
Maria Eduarda Leite
ME
Figueiredo
Rita
R
Carvalho
Dora
D
Catre
José Pedro
JP
Assunção
D000758:Anesthesia / Q000379:methods; D006801:Humans; D055806:Microvessels; D019651:Plastic Surgery Procedures / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply*