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Lipo‐prostaglandin E1 increases immediate arterial maximal flow velocity of free flap in patients undergoing reconstructive surgery
Author(s) -
Jin SeokJoon,
Suh Hyunsuk Peter,
Lee Joonho,
Hwang JaiHyun,
Hong Joon Pio Jp,
Kim YoungKug
Publication year - 2019
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.13217
Subject(s) - medicine , prostaglandin e1 , hemodynamics , anesthesia , blood flow , blood pressure , anastomosis , surgery , mean arterial pressure , prostaglandin e , heart rate , cardiology
Background In free flap surgery, the maintenance of proper blood flow after anastomosis of flap pedicle vessels is important. Lipo‐prostaglandin E1 (lipo‐ PGE 1) has been empirically administered to prevent blood flow insufficiency in a free flap reconstruction. We tested our hypothesis that lipo‐ PGE 1 administration increases the arterial inflow of free flap. We also evaluated lipo‐ PGE 1‐related haemodynamic changes and complications. Methods Thirty‐seven patients who underwent free flap reconstruction were analysed. Lipo‐ PGE 1 was administered 10 minutes after the vascular anastomosis of the free flap. The maximal blood flow velocity was measured at the free flap pedicle artery before and 30 minutes after lipo‐ PGE 1 administration using duplex ultrasonography. The primary outcome was the difference in the maximal blood flow velocity before and 30 minutes after lipo‐ PGE 1 administration. The arterial blood pressure, heart rate, cardiac output, stroke volume variation, and pulse pressure variation were measured simultaneously. Lipo‐ PGE 1‐related complications such as hypotension, bradycardia, hypothermia, facial flushing, diarrhoea, apnoea, and seizure were also investigated. Results The maximal blood flow velocity was significantly increased at 30 minutes after lipo‐ PGE 1 administration compared to the level before lipo‐ PGE 1 administration (mean (standard deviation): 26.3 (8.7) cm/s vs 22.5 (8.0) cm/s, P = 0.002). The haemodynamic variables were not significantly different before and 30 minutes after lipo‐ PGE 1 administration. No lipo‐ PGE 1‐related complications occurred. Conclusions Lipo‐ PGE 1 significantly increases the maximal blood flow velocity without complications in patients undergoing free flap reconstruction and may be an effective and safe method of maintaining adequate blood flow in these cases.