An Assessment of the Effects of Pressors on Graft Blood Flow After Free Tissue Transfer Surgery: A Randomised Study
The optimal sympathomimetic drug to support blood pressure without adverse vasoconstriction
of free flap circulation remains unknown. This study examined the effects of four agents
(epinephrine, norepinephrine, dobutamine and dopexamine) on free flaps following resection
of head and neck cancer.
Twenty five patients were recruited to the study. Each patient received an infusion of the
four drugs in a random order with an intervening washout period between drugs, at four
infusion rates. Continuous free flap skin blood flow monitoring was performed using laser
Doppler velocimetry, with a second sensor on normal skin acting as a control. Global
cardiovascular variables were monitored using the LiDCO Rapid pulse contour analysis system.
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic
Absolute change in transfer function (flap vascular resistance) after pressor infusion.
Post infusion (at 4 hours)
Stephen R Watt-Smith, FDSRCS, MD
Oxford University Hospitals NHS Trust
United Kingdom: Medicines and Healthcare Products Regulatory Agency