Additional Criteria For Assessing the Effectiveness of Anesthesia in the Process of RPO (Reconstructive Plastic Surgery) In Patients with Post-Burning Contractures of the Face, Neck and Chest
DOI:
https://doi.org/10.62480/tjms.2022.vol8.pp22-27Keywords:
reconstructive plastic surgery, methods of anesthesia, regional anesthesia, oxygen pressureAbstract
56 patients aged 16 to 50 were under the experience of reconstructive plastic surgery for postburn contractures of the face, neck and chest. According to the anesthetic manual we used, the patients were divided into 2 groups: in the first (1) group - 27 patients (48.2%) used regional anesthesia (blockade of the cervical plexus and 3 branches of the trigeminal nerve). In the second (2) group of 29 patients (51.8%), reconstructive plastic surgery (RPS) was performed under the conditions of total intravenous anesthesia with benzodiazepines, ketamine, fentanyl with myoplegiaarduan in standard age dosages. Oxygen pressure in the soft tissue (PTKO2) of the operated area was examined using a Clark-type transducer using percutaneous contact polarography. The temperature was measured with an electric thermometer with fixation of the central T1C (oral cavity) and peripheral T2C (subclavian region), as well as the affected area T3C. Compared temperature gradients of the flaps at the stages in the groups indicate (indirectly) a microcirculation with regional anesthesia better than TVA. Our obtained results according to the data of thermometry of the flaps at the stages of surgical intervention are quite consistent with those changes in oxygen tension in the tissues of the flap (PTKO2-) in the patients examined by us. This resultsare less complicated in the operated tissues rather than other proven anesthesia methods when using regional anesthesia.
References
Altermatt F.R.,Munoz H.R., Delfino A.E., Cortinez L.I. Preoxygenation in the obese patient; effects of position on tolerance to apnea. Br.J.Anaesth.2005;95;706-709.DOI:10.1093/bja/aei231
Ander F.,Magnuson A de Leon A., Ahlstrand R.Does the B-receptor angtagoist esmolol have analgesic effects? A randomized placebo-controlled cross-over study on healthy voluntreers undergoing the cold pressor test.European Journal of Andaesthesiology.2018;359(3);165-172.DOI;10. 1097/ EJA.0000000000000711
Popat M., Mitchell V., Dravid R., Patel A., Swampillai C., Higgs A. Difficult Airway Society Guildelines for the management of tracheal extubation. Anaesthesia 2012;67(3);318-340.DOI;10.1111/j.1365-2044. 2012. 07075.x
Dixon B.J., Dixon J.B., Carden J.R,ey al. Preoxygenation is more effective in the 25 head-up position than in the supine position in severely obese patients: a randomized controlled study. Anesthesiology.2005;102;1110-1115
Finfer S., Chittock DR,SU SY,et al. Intensive versus conventional glucose control in critically ill patients.N Engl J.Med 2009;360:1283-1297
Gasser A., Forbes RM. Advanced glycation: Implications in tissue damage and disease. Protein Pept Lett.2008;15:385-391
Gelineau AM,KING MR Ladhe KS,BURns SM,Houle T, Anderson TA. Intraoperative esmolol as an adjunct for perioperative opioid and postoperative pain reduction: A systematic review, meta-analysis, and meta-regression. Anesthesia and Analgesia.2018;
Goldberg M.E.,Norris M.C.,Linjani G.E,et al. Preoxygenation in the morbidly obese: A comparison of two techniques.Anesth.Anagl.1989;68,520-522.
Greenhalgh DG Wound healing and diabetes mellitus. Clin Plast Surg 2003;30:37-45
Griesdale DE,de Souza RJ,van Dam RM,et al. Intensive insulin therapy and mortality among critically ill patients: A metaanalysis including NICE-SUGAR study data. CMAJ 2009;180:821-827
Hatef D.A., Nguyen M.Q,et al. Thromboebolic risk assessment and the efficacy of enoxaparin prophylaxis in excisional body contouring surgery. Plast Reconstr Surg.2008;122:1093-1103.
Latham R.,Lancaster A.D.,Covington J.F.,Pirolo J.S.,Thomes C.S Jr. The association of diabetes and glucose control with surgical site infections among cardiothoracic surgery patients. Infect Control Hops Epidemiol.2001;22:607-612
Novitsky Y.W., Orenstein S.B. Effect of patient and hospital characteristics on outcomes of elective ventral hernia repair in the United Staes.Hernia 2013;248:639-645
Onah J.J. A classification System for Postburn Mentosternal Contractures Arch.Surg.,2005,V140,p671-675
Pannucci C.J.,Dreszer G.,Wachtman C.F.,et al.Postoperative enoxaparin prevents’ symptomatic venous thromboembolism in high-risk plastic surgery. Plast. Reconstr Surg.2011;128;1093-1103
Queenie Hy Mak, Hing T.Ch, Michael Y.J. Anesthesia for plastic and reconstructive surgery Anesth. and inteks. Care Med.,2022,1,64-69
Ramos M., Khalpey Z.,Lipsitz S,et al.Relationship of preoperative hyperglycemia and postoperative infections in patients who undergo general and vascular surgery. Ann surg.2008;248:585-591
Schnell D.,Planquette B.,Berger A. et al. Cuff Leak Test for the Diagnosis of Post-Extubation Stridor J. Intensive Care Med.2017.
Shady N., Hayek, Arij M.El et al. Does Surgical release of neck burn contracture result in airway improvement? S. of Anesthesia and Critical care,2017,7(6),14
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
User Rights
Under the Creative Commons Attribution-NonCommercial 4.0 International (CC-BY-NC), the author (s) and users are free to share (copy, distribute and transmit the contribution).
Rights of Authors
Authors retain the following rights:
1. Copyright and other proprietary rights relating to the article, such as patent rights,
2. the right to use the substance of the article in future works, including lectures and books,
3. the right to reproduce the article for own purposes, provided the copies are not offered for sale,
4. the right to self-archive the article.
