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British Journal of Anaesthesia, 1985, Vol. 57, No. 9 904-912
© 1985 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

ANAESTHESIA FOR MICROVASCULAR SURGERY

A Physiological Approcach

D. J. F. MACDONALD, M.B.,CH.B.,F.F.A.R.C.S.,D.A.,D.T.M.H.,*

The anaesthetic management of patients for microvascular free transfer surgery requires a sound knowledge of circulatory physiology. It is important to maintain adequate arterial pressure andcardiacoutput.Hypervoaemichaemodilution to a haematocrit of about 35% increases the cardiac output and improves flow in the micro-circulation. Systemic heat loss must be minimized and the transplant itself kept warm. Hypocapnia is to be avoided. Analgesia must be adequate. The degree of any induced vasodilatation must be balanced against the effect on the systemic arterial pressure. Measures instituted in theatre to produce optimum circulatory conditions must be maintained in the postoperative period.

*Division Of Anaesthesia,Royal Infirmary,Glasgow,G31 2ER;and Glasgow and West Scotland Regional Centre for Plastic Surgery,Caniesburn Hospital,Bearsden,Glasgow G61

*Address for reprints


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