Anaesthesia for patients undergoing prolonged reconstructive and microvascular plastic surgery

Area of Science:

• Anesthesiology
• Plastic Surgery
• Patient Outcomes

Background:

• Prolonged reconstructive plastic surgery presents unique anesthesiological challenges.
• Understanding potential complications is crucial for patient safety.

Purpose of the Study:

• To investigate anesthesiological problems in patients undergoing prolonged reconstructive plastic surgery.
• To evaluate patient outcomes and subjective complaints following extended surgical procedures.

Main Methods:

• Retrospective analysis of 22 patients undergoing reconstructive plastic surgery with durations from 5 to 15 hours.
• Monitoring of central temperature and hematocrit levels; dextran used for blood loss replacement.
• Postoperative patient questionnaires assessing subjective experiences.

Main Results:

• No serious cardiovascular complications occurred in young, healthy patients.
• Transient hand muscle paresis observed in 2 patients; nausea and bladder catheterization sensations were predominant subjective complaints.
• Laryngeal edema in one patient and breathing difficulties in a third upon awakening were noted; postoperative pain was minimal.

Conclusions:

• Prolonged reconstructive plastic surgery can be managed with minimal cardiovascular complications in suitable patients.
• Awareness of potential issues like transient paresis, nausea, and airway complications is important for postoperative care.
• Patient-reported outcomes highlight the need for managing specific discomforts and airway management post-extubation.