TY - JOUR
T1 - Effects of vasopressor administration on the outcomes of microsurgical breast reconstruction
AU - Chen, Chen
AU - Nguyen, Minh Doan
AU - Bar-Meir, Eran
AU - Hess, Philip A.
AU - Lin, Samuel
AU - Tobias, Adam M.
AU - Upton, Joseph
AU - Lee, Bernard T.
PY - 2010/7
Y1 - 2010/7
N2 - The use of vasopressors during microsurgery is still debated. General anesthesia often induces hypotension, but microsurgeons are reluctant to use intraoperative vasopressors with the potential risks of vasoconstriction. A retrospective review was performed on 187 consecutive patients undergoing 258 deep inferior pigastric perforator flaps, free transverse rectus abdominis myocutaneous flap, and muscle-sparing free transverse rectus abdominis myocutaneous flap operations. A total of 102 patients (140 flaps) received intraoperative ephedrine and/or phenylephrine and 85 patients (118 flaps) did not. The administration of vasopressors did not affect the rates of reoperation, complete flap loss, partial flap loss, or fat necrosis. Patients receiving vasopressors had no differences in operative time, number of perforators, or number of rows of perforators harvested. There was no statistically significant association between dosage, timing, and complications. Although we do not recommend routine vasopressor use during microsurgery, administration does not seem to increase complications in microsurgical breast reconstruction.
AB - The use of vasopressors during microsurgery is still debated. General anesthesia often induces hypotension, but microsurgeons are reluctant to use intraoperative vasopressors with the potential risks of vasoconstriction. A retrospective review was performed on 187 consecutive patients undergoing 258 deep inferior pigastric perforator flaps, free transverse rectus abdominis myocutaneous flap, and muscle-sparing free transverse rectus abdominis myocutaneous flap operations. A total of 102 patients (140 flaps) received intraoperative ephedrine and/or phenylephrine and 85 patients (118 flaps) did not. The administration of vasopressors did not affect the rates of reoperation, complete flap loss, partial flap loss, or fat necrosis. Patients receiving vasopressors had no differences in operative time, number of perforators, or number of rows of perforators harvested. There was no statistically significant association between dosage, timing, and complications. Although we do not recommend routine vasopressor use during microsurgery, administration does not seem to increase complications in microsurgical breast reconstruction.
KW - breast reconstruction
KW - flap loss
KW - microsurgery
KW - vasopressors
UR - http://www.scopus.com/inward/record.url?scp=77954242379&partnerID=8YFLogxK
U2 - 10.1097/sap.0b013e3181bda312
DO - 10.1097/sap.0b013e3181bda312
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C2 - 20548236
AN - SCOPUS:77954242379
SN - 0148-7043
VL - 65
SP - 28
EP - 31
JO - Annals of Plastic Surgery
JF - Annals of Plastic Surgery
IS - 1
ER -