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This study aimed to evaluate the possible protective effect of anesthetic technique balanced(with sevoflurane) compared with total intravenous anesthetic technique (propofol,remifentanil). The hypothesis is that the Sevoflurane may exert protective effect in regard to the ischemia-reperfusion injury induced on the microsurgical breast free flap during transfer to receiving area. The investigators will evaluate the continuous flap tissue oximetry and the level of biochemical markers.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Total intravenous anesthesia | Active Comparator | Total intravenous anaesthesia |
|
| Balanced anesthesia | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Balanced anesthesia | Drug | Et-Sevo maIntained 1,8-2%, remifentanyl according target-controlled infusion maintained 1-3 ng/ml |
|
| Measure | Description | Time Frame |
|---|---|---|
| continuous tissue oximetry (NIRS) | 20 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Biochemical Markers | Preoperative and 24 hours post operative | |
| Lactate Clearance | 24 hours |
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Inclusion Criteria:
Patient selected for plastic breast surgery With microsurgical Free flap Over 18 y Asa I/II
Exclusion Criteria:
Unusual reaction to anesthetic drugs Suspect for malignant hyperthermia Vasculopathic disease Coagulation disease
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| Name | Affiliation | Role |
|---|---|---|
| Ester Forastiere, M.D. | Regina Elena CI | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Regina Elena CI | Rome | Italy | 00144 | Italy |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27549313 | Derived | Claroni C, Torregiani G, Covotta M, Sofra M, Scotto Di Uccio A, Marcelli ME, Naccarato A, Forastiere E. Protective effect of sevoflurane preconditioning on ischemia-reperfusion injury in patients undergoing reconstructive plastic surgery with microsurgical flap, a randomized controlled trial. BMC Anesthesiol. 2016 Aug 22;16(1):66. doi: 10.1186/s12871-016-0230-1. |
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| ID | Term |
|---|---|
| D015427 | Reperfusion Injury |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
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| ID | Term |
|---|---|
| D058126 | Balanced Anesthesia |
| D000769 | Anesthesia, Inhalation |
| ID | Term |
|---|---|
| D000768 | Anesthesia, General |
| D000758 | Anesthesia |
| D000760 | Anesthesia and Analgesia |
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| Total intravenous anesthesia | Drug | Propofol 3-4 µg/ml and remifentanyl 1-3 ng/ml according target-controlled infusion |
|
|
| D013568 | Pathological Conditions, Signs and Symptoms |