The effect of epidural anesthesia on muscle flap tolerance to venous ischemia

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dc.citation.epage98en_US
dc.citation.issueNumber1en_US
dc.citation.spage89en_US
dc.citation.volumeNumber125en_US
dc.contributor.authorCayci, C.en_US
dc.contributor.authorCinar, C.en_US
dc.contributor.authorYucel, O. A.en_US
dc.contributor.authorTekinay, T.en_US
dc.contributor.authorAscherman, J. A.en_US
dc.date.accessioned2016-02-08T10:00:36Z
dc.date.available2016-02-08T10:00:36Z
dc.date.issued2010en_US
dc.departmentInstitute of Materials Science and Nanotechnology (UNAM)en_US
dc.description.abstractBackground: Venous ischemia is a major cause of failure after free tissue transfers and replantations. The combination of general and epidural anesthesia leads to vasodilatation and improves tissue perfusion. Postoperative pain relief and sympathetic blockage are additional benefits of epidural anesthesia. The purpose of this study was to determine whether epidural anesthesia has benefits on microcirculation and neutrophil functions in muscle flaps subjected to venous ischemia. Method: Thirty Sprague-Dawley rats were divided into three groups: group I, general anesthesia; group II, spinal anesthesia; and group III, epidural anesthesia. Cremaster flaps were prepared, postcapillary venules were selected under intravital videomicroscopy, and flaps were subjected to venous ischemia. Images were recorded from preselected postcapillary venules before venous ischemia (baseline) and following reperfusion. Neutrophil rolling and adhesion, functional capillary density, and diameters of postcapillary venules were evaluated. Results: The increase in rolling neutrophils in group III was significantly lower than in groups I and II at 60 and 120 minutes. Change of adherent neutrophils in group III was significantly lower than in groups I and II at 15, 60 and 120 minutes. There was significantly more reduction in inner diameter of postcapillary venules in groups I and II compared with group III. Functional capillary density in groups I and II was significantly lower than in group III. Conclusion: Epidural anesthesia regulated neutrophil functions, salvaged functional capillaries, and prevented vasoconstriction of postcapillary venules in cremaster muscle flaps subjected to venous ischemia. Spinal and general anesthesia, however, were found to be ineffective in improving microcirculation of muscle flaps subjected to venous ischemia.en_US
dc.identifier.doi10.1097/PRS.0b013e3181c49544en_US
dc.identifier.issn0032-1052
dc.identifier.urihttp://hdl.handle.net/11693/22475
dc.language.isoEnglishen_US
dc.publisherLippincott Williams & Wilkinsen_US
dc.relation.isversionofhttps://doi.org/10.1097/PRS.0b013e3181c49544en_US
dc.source.titlePlastic and Reconstructive Surgeryen_US
dc.subjectAnimalen_US
dc.subjectCapillaryen_US
dc.subjectEpidural anesthesiaen_US
dc.subjectIschemiaen_US
dc.subjectMicrocirculationen_US
dc.subjectNeutrophilen_US
dc.subjectPathophysiologyen_US
dc.subjectPhysiologyen_US
dc.subjectPlastic surgeryen_US
dc.subjectRaten_US
dc.subjectVascularizationen_US
dc.subjectNeutrophilsen_US
dc.subjectSurgical flapsen_US
dc.titleThe effect of epidural anesthesia on muscle flap tolerance to venous ischemiaen_US
dc.typeArticleen_US
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