Regional anesthesia for microsurgery in China: a review.

Between June 1968 and December 1985, a total of 1185 microsurgical operations were performed at the No. 6 Municipal Hospital, Shanghai. These included 500 reimplantations of amputated hands or fingers, 271 free transfers of toes, 96 free transfers of fibula, 63 free transfers of muscle, 34 reconstructions of hands, and 88 ENT procedures. The anesthetic methods used were brachial plexus block 401 (33.8%), cervical epidural block 232 (19.6%), general anesthesia 193 16.3%), double catheter lumbar and cervical epidural block 149 (12.6%), brachial plexus plus lumbar epidural block 123 (10.4%), lumbar epidural block alone 64 (5.4%), and acupuncture 22 (1.9%). Anesthesia in microsurgical operations must provide good operating conditions for very prolonged periods, devoid of any vasospasm and preferably with a degree of vasodilatation to facilitate vascular anastomosis.