Review Note
Last Update: 03/30/2025 10:26 PM
Current Deck: ACG Part 2::Plastic Surgery and Burns
New Card (Unpublished)Currently Published Content
Front
Back
No published tags.
Pending Suggestions
Field Change Suggestions:
Front
Commit #312107
SS_PB 1.1 Describe the physiological principles relevant to optimising blood flow to tissue flaps, including
- The integrated cardiovascular responses to anaesthesia and a central neuraxial block
- The integrated cardiovascular responses to anaesthesia and a central neuraxial block
Back
Commit #312107
Effects of Anaesthesia on Cardiovascular Function
-
Sympathetic Nervous System (SNS) Depression: Causes vasodilation, bradycardia, and reduced contractility, leading to reduced cardiac output (CO) and hypotension.
-
Reduced Baroreceptor Sensitivity: Impaired ability to maintain blood pressure, leading to potential hypotension and reduced tissue perfusion.
-
Decreased Cardiac Output: Due to reduced preload, afterload, and myocardial contractility.
-
Sympathetic Blockade: Blocks sympathetic outflow below the level of the block, causing vasodilation, hypotension, and reduced preload.
-
Hypotension: Decreased systemic vascular resistance (SVR) and venous pooling can reduce cardiac output and perfusion pressure, impacting tissue flap viability.
-
Redistribution of Blood Volume: Blood pools in central veins, reducing flow to peripheral tissues (including flaps).
-
Fluid Resuscitation: Increase preload to counteract venous pooling and restore perfusion pressure.
-
Vasopressors: Use of phenylephrine or norepinephrine to restore SVR and maintain blood pressure.
-
Heart Rate Management: If bradycardia occurs, use anticholinergics (e.g., atropine) to increase heart rate.
-
Positioning: Elevate flaps to improve venous return and reduce venous congestion.
-
Temperature Control: Prevent hypothermia, as it may cause vasoconstriction and reduce perfusion.
-
Continuous Monitoring: Regularly assess blood pressure, heart rate, and flap perfusion for early signs of compromised circulation.