Arterial Pressure Management in a Reconstructive Microsurgery Patients by Dopamine Infusion in a Nonintensive Care Ward

Free flap perfusion and arterial pressure management have always had a crucial role in free flap reconstruction. Blood pressure values requested can be reached either by using vasoactive agents or fluid replacement or the combination of both.1,2 In contrast to the most frequently tested phenylephrine, norepinephrine, and dobutamine,3,4 this work evaluates dopamine efficacy in perioperative blood pressure management. In our institution, dopamine infusion is the only vasoactive agent authorized in a non-intensive care unit department. This drug stimulates \u3b1- and \u3b2-adrenergic receptors with positive chronotropic and inotropic effects and reduces peripheral vascular resistance helping in this way to achieve an increase of blood pressure and free flap perfusion.

The Use of Near Infrared Spectroscopy (NIRS) for Monitoring of Free Flaps

Free flaps have been introduced in reconstructive surgery in the late 1960s. Since then, because of many improvements (better knowledge of anatomy and physiology, improved techniques of flap harvesting and inset, microsurgical techniques, progress from musculocutaneous, through fasciocutaneous to perforator fl aps, more dependable and user-friendly fl ap monitoring devices) success rates of more than 95 % are constantly being reported in the literature