TY - JOUR
T1 - Epidural Combined with General Anesthesia versus General Anesthesia Alone in Patients Undergoing Free Flap Breast Reconstruction
AU - Lou, Feifei
AU - Sun, Zhirong
AU - Huang, Naisi
AU - Hu, Zhen
AU - Cao, Ayong
AU - Shen, Zhenzhou
AU - Shao, Zhimin
AU - Yu, Peirong
AU - Miao, Changhong
AU - Wu, Jiong
N1 - Publisher Copyright:
Copyright © 2015 by the American Society of Plastic Surgeons.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Background: Addition of epidural anesthesia may have several benefits. The purpose of this study was to investigate the effectiveness and safety of epidural anesthesia combined with general anesthesia in patients undergoing free flap breast reconstruction. Methods: A retrospective chart review identified 99 patients who underwent free flap breast reconstruction under general anesthesia alone (46 patients) or general anesthesia plus epidural anesthesia (53 patients) between 2011 and 2014. Mean arterial blood pressure was measured before induction, after flap elevation but before flap transfer, 15 minutes after flap revascularization, and at the end of surgery. Postoperative pain was assessed using a visual analogue scale. Results: The incidence of flap thrombosis was 3.8 percent in the epidural anesthesia/general anesthesia group versus 4.3 percent in the general anesthesia group (p = 1). Flap failure was 0 percent in the epidural anesthesia/general anesthesia group versus 4.3 percent in the general anesthesia group (p = 0.213). Patients in the epidural anesthesia/general anesthesia group had lower visual analogue scale scores at 2 hours (0.76 ± 0.62 versus 2.58 ± 0.99; p < 0.001), 6 hours (1.94 ± 1.19 versus 4.04 ± 1.46; p < 0.001), and 24 hours (0.74 ± 0.69 versus 1.56 ± 1.01; p < 0.001) postoperatively. Mean arterial blood pressure was lower in the epidural anesthesia/general anesthesia group after flap elevation but before flap transfer, 15 minutes after flap revascularization, and at the end of surgery. Conclusion: Epidural anesthesia/general anesthesia combination improves postoperative pain and side effects without increasing the risk of flap thrombosis.
AB - Background: Addition of epidural anesthesia may have several benefits. The purpose of this study was to investigate the effectiveness and safety of epidural anesthesia combined with general anesthesia in patients undergoing free flap breast reconstruction. Methods: A retrospective chart review identified 99 patients who underwent free flap breast reconstruction under general anesthesia alone (46 patients) or general anesthesia plus epidural anesthesia (53 patients) between 2011 and 2014. Mean arterial blood pressure was measured before induction, after flap elevation but before flap transfer, 15 minutes after flap revascularization, and at the end of surgery. Postoperative pain was assessed using a visual analogue scale. Results: The incidence of flap thrombosis was 3.8 percent in the epidural anesthesia/general anesthesia group versus 4.3 percent in the general anesthesia group (p = 1). Flap failure was 0 percent in the epidural anesthesia/general anesthesia group versus 4.3 percent in the general anesthesia group (p = 0.213). Patients in the epidural anesthesia/general anesthesia group had lower visual analogue scale scores at 2 hours (0.76 ± 0.62 versus 2.58 ± 0.99; p < 0.001), 6 hours (1.94 ± 1.19 versus 4.04 ± 1.46; p < 0.001), and 24 hours (0.74 ± 0.69 versus 1.56 ± 1.01; p < 0.001) postoperatively. Mean arterial blood pressure was lower in the epidural anesthesia/general anesthesia group after flap elevation but before flap transfer, 15 minutes after flap revascularization, and at the end of surgery. Conclusion: Epidural anesthesia/general anesthesia combination improves postoperative pain and side effects without increasing the risk of flap thrombosis.
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U2 - 10.1097/01.prs.0000479933.75887.82
DO - 10.1097/01.prs.0000479933.75887.82
M3 - Article
C2 - 26910694
AN - SCOPUS:84959360390
SN - 0032-1052
VL - 137
SP - 502e-509e
JO - Plastic and reconstructive surgery
JF - Plastic and reconstructive surgery
IS - 3
ER -