Intraoperative Use of Vasopressors Is Safe in Head and Neck Free Tissue Transfer.
J Reconstr Microsurg
; 32(2): 87-93, 2016 Feb.
Article
em En
| MEDLINE
| ID: mdl-26340760
ABSTRACT
BACKGROUND:
The purpose of this study is to identify whether intraoperative use of vasoactive medications increases the risk of free flap failure or complications through a systematic review and meta-analysis. MATERIALS ANDMETHODS:
PubMed/MEDLINE, EMBASE, and Scopus databases were searched for studies published through January 2015. English publications that met the following criteria were included (1) adult patients undergoing head and neck free flap reconstruction; (2) comparison of patients with and without intraoperative vasopressor administration; and (3) documentation of flap failure rate and/or flap complications. The primary outcome was the incidence of flap failure. The secondary outcome was the incidence of overall flap complications. Meta-analysis was performed to obtain pooled odds ratios (ORs) of the effect of intraoperative use of vasopressors on flap failure and complication rates.RESULTS:
Four cohort studies met inclusion criteria. All studies were of high methodological quality with an average Methodological Index for Non-Randomized Studies score of 18.75 (range 16-23). A total of 933 patients undergoing head and neck free flap reconstruction were included. Meta-analysis demonstrated no statistically significant difference in the incidence of flap failure (2.9 vs. 3.6%; OR, 0.68; 95% confidence interval [CI], 0.23-1.99; p = 0.48) or incidence of flap complications (16.8 vs. 18.6%; OR, 0.92; 95% CI, 0.60-1.42; p = 0.71).CONCLUSION:
Based on the current evidence, intraoperative use of vasopressors has no impact on the incidence of flap failure or flap complications.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Vasoconstritores
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Procedimentos de Cirurgia Plástica
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Retalhos de Tecido Biológico
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Neoplasias de Cabeça e Pescoço
Tipo de estudo:
Etiology_studies
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Observational_studies
/
Prognostic_studies
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Risk_factors_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
J Reconstr Microsurg
Assunto da revista:
NEUROCIRURGIA
Ano de publicação:
2016
Tipo de documento:
Article