Free Tissue Flaps
Conditions
Brief summary
Comparing the changes of arterial anastomotic blood flow between general anesthesia alone and general anesthesia with epidural anesthesia in patients who undergoing free flap transposition using Duplex ultrasound.
Detailed description
Maintaining adequate blood flow is important on the success of free flap surgery. Epidural anesthesia can influence blood flow during surgery. Therefore, investigators aim to compare the effect of epidural anesthesia combined with general anesthesia and general anesthesia alone on blood flow in arterial anastomosis site of the free flap.
Interventions
OTHEREpidural anesthesia
After anesthesia induction, epidural catheter is inserted into lumbar epidural in epidural with general anesthesia group. A 10 ml of 0.2% ropivacaine should be given in epidural space via a catheter when anastomosis of free flap is finished in epidural with general anesthesia group.
Sponsors
Asan Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 79 Years
Healthy volunteers
No
Inclusion criteria
* Patients scheduled to undergo free flap transfer under general anesthesia. * 18 years of age or older, under 80 years of age * Those who voluntarily agreed to participate in this clinical study
Exclusion criteria
* If the patient does not agree to participate in the study * ASA physical status IV or higher * If the patient was diagnosed with diabetes * If the patient was diagnosed with chronic renal failure * If the patient was diagnosed with peripheral vascular disease or hyperlipidemia * If vasopressors or inotropics was used preoperatively. * Contraindication of epidural anesthesia such as usage of anticoagulant or abnormalities of laboratory finding. * If the researcher finds it to be inappropriate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Maximal blood flow velocity | 30 minutes after flap arterial anastomosis | Maximal blood flow velocity measured by using Duplex ultrasound |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Arterial blood pressure | 30 minutes after flap arterial anastomosis | Arterial blood pressure measured monitors |
| Cardiac output | 30 minutes after flap arterial anastomosis | Cardiac output measured monitors |
| Pulse pressure variability | 30 minutes after flap arterial anastomosis | Pulse pressure variability measured monitors |
| Blood volume | 30 minutes after flap arterial anastomosis | Blood volume measured by using Duplex ultrasound |
| Arterial carbon dioxide concentration | 30 minutes after flap arterial anastomosis | Arterial carbon dioxide concentration measured arterial blood gas analysis |
| Free flap failure | Day 7 after free flap surgery | Free flap failure after surgery |
| Body temperature | 30 minutes after flap arterial anastomosis | Body temperature measured monitors |
Countries
South Korea
Outcome results
None listed