Abstract
Objective: Identify if the use of an intraoperative vasopressor increases the risk of microvascular free flap failure or affects the rate of complications.
Method: A retrospective chart review performed between November 2008 and November 2010 of patients undergoing head and neck microvascular reconstruction. Flap type, ASA classification, use of a vasopressor, and fluid status were documented and analyzed with respect to flap failure and complications. A Fisher exact test was used for statistical analysis.
Results: Eighty-six patients underwent microvascular reconstruction during the study period. No patients were excluded. Seventy-six (88.4%) patients received at least 1 vasopressor intraoperatively. Ten (11.6%) did not have administration of vasopressors. Total flap failure occurred in 3 (3.5%) patients. All flap failures occurred in patients that received vasopressors (3.9%) (P = .696). Flap complications (intraoperative clot requiring revision anastomosis, leech therapy, or flap failure) occurred in 11 (12.8%) patients, including 2 (20%) of the patients that did not receive a vasopressor and 9 (11.8%) of the patients that received a vasopressor (P = .408).
Conclusion: The use of vasopressors in head and neck microvascular reconstruction is very common. There is no evidence that vasopressors have an effect on microvascular free flap survival or complications.
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