Anaesthetic management for head and neck cancer surgery with free-flaps

I. Preseglio, F. Cimino, M. Ilardi, A. Giordano, M. P. Del Monte

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Anaesthetic problems in head and neck cancer surgery with free flaps, are connected with: long term of operations, blood and fluid losses and changes in blood flow at the transferred tissues. From November 1995 to August 1997, 23 patients underwent to different kinds of free flap: 12 jejunum, 4 forearm, 4 iliac crest, 1 lateral thigh, 1 abdominal rectus muscle and 1 fibula. Great importance was given to the positioning on the operating bed to avoid bedsores and lose of heat. The prevention of transferred tissue ischaemia was obtained with bolus of heparine, isovolemic hemodilution and, if necessary, with inotropic drugs. The mean duration of operations was 608 minutes (range 820-480); 4 patients were transfused with red blood cells, fresh frozen plasma and autologous blood; heat loss was meanly 1°C; fluids speed infusion (cristalloids and colloids) was 5-10 ml/kg/h. The most important goal is to prevent the ischaemia of the flap by an adeguate blood flow to the transferred tissue. Besides the long procedure, the extensive surgery and the blood and fluid losses cause hypothermia and hypovolaemia, which predispose to peripheral vasocostriction.

Original languageEnglish
Pages (from-to)119-122
Number of pages4
JournalMedecine Biologie Environment
Issue number2
Publication statusPublished - 1997


  • Anaesthetic management
  • Free-flap
  • Head and neck cancer
  • Surgery

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)


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