Epinephrine, Norepinephrine, Dobutamine, and Dopexamine Effects on Free Flap Skin Blood Flow

Eley KA, Young JD, Watt-Smith SR (Univ of Oxford, UK) Plast Reconstr Surg 130:564-570, 2012^§

Abstract

Background

The optimal sympathomimetic drug to support blood pressure without adverse vasoconstriction of free flap circulation remains unknown. This study examined the effects of four agents (epinephrine, norepinephrine, dobutamine, and dopexamine) on free flaps following resection of head and neck cancer.

Methods

Twenty-four patients (25 data sets) were recruited into the study. Each patient received an infusion of the four drugs in a random order, with an intervening washout period between drugs, at four infusion rates. Continuous free flap skin blood flow monitoring was performed using laser Doppler velocimetry, with a second sensor on normal skin acting as a control. Global cardiovascular variables were monitored using the LiDCO Rapid Pulse Contour Analysis System (LiDCO Ltd., Cambridge, United Kingdom).

Results

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