Dohar J E, Goding G S, Maisel R H
Department of Otolaryngology-Head and Neck Surgery, Hennepin County Medical Center, University of Minnesota, Minneapolis 55415.
Arch Otolaryngol Head Neck Surg. 1992 Jan;118(1):37-40. doi: 10.1001/archotol.1992.01880010041013.
In recent years a myriad of studies have been performed investigating the effects on flap survival of various pharmacologic agents. One class of agents, however, that has received relatively little attention is the inhalational anesthetics. Yet, they are widely used during reconstructive efforts using skin flaps and they possess several pharmacologic properties shown to affect flap survival. Using a dorsally based random skin flap model in 28 swine, the influence of nitrous oxide and isoflurane on skin flap survival was examined. The mean area of skin flap survival in the isoflurane, nitrous oxide, euoxemic control, and hyperoxygenated control groups was 79.4%, 29.7%, 42.0%, and 28.6%, respectively. A significant improvement in flap viability was seen only in the group using isoflurane as the anesthetic agent. Arterial blood gas content (PO2, PCO2, and HCO3), respiratory rate, acid-base balance, blood pressure, pulse, and temperature were monitored. Improved survival of the isoflurane group was independent of these parameters. These data suggest that the choice of anesthetic agent may effect random skin flap survival with isoflurane providing the greatest benefit of the agents tested in this model.
近年来，人们进行了大量研究，探讨各种药物制剂对皮瓣存活的影响。然而，一类相对较少受到关注的药物制剂是吸入性麻醉剂。不过，它们在使用皮瓣的重建手术中被广泛使用，并且具有一些已被证明会影响皮瓣存活的药理特性。在28头猪身上使用背部随意型皮瓣模型，研究了氧化亚氮和异氟烷对皮瓣存活的影响。异氟烷组、氧化亚氮组、正常氧合对照组和高氧对照组的皮瓣存活平均面积分别为79.4%、29.7%、42.0%和28.6%。仅在使用异氟烷作为麻醉剂的组中观察到皮瓣活力有显著改善。监测了动脉血气含量（PO2、PCO2和HCO3）、呼吸频率、酸碱平衡、血压、脉搏和体温。异氟烷组皮瓣存活率的提高与这些参数无关。这些数据表明，麻醉剂的选择可能会影响随意型皮瓣的存活，在该模型中测试的药物制剂中，异氟烷提供的益处最大。
