Increased anesthesia duration is associated with significantly increased rates of surgical complications, especially the need for postoperative transfusion, among patients undergoing microvascular reconstruction of the head and neck, according to a study published online Oct. 5 in JAMA Facial Plastic Surgery.
Jacob S. Brady, from Rutgers New Jersey Medical School in Newark, and colleagues used the American College of Surgeons National Surgical Quality Improvement Program database to identify 630 patients who underwent head and neck microvascular reconstruction between Jan. 1, 2005, and Dec. 31, 2013. Patients were characterized based on mean anesthesia duration.
The researchers found that increasing anesthesia duration was associated with increased 30-day complications overall (P = 0.006), increased 30-day postoperative surgical complications overall (P < 0.001), increased rates of postoperative transfusion (P < 0.001), and increased rates of wound disruption (P = 0.02). Increased anesthesia duration was not associated with any specific medical complications or overall medical complication rate (P = 0.80) or mortality (P = 0.75). When accounting for demographics and significant preoperative factors, including free flap type, overall complications (P = 0.02), surgical complications (P = 0.003), and postoperative transfusion (P = 0.006) remained significantly associated with increased anesthesia duration.
“Avoidance of excessive blood loss and prolonged anesthesia time should be the goal when performing head and neck free flap surgery,” the authors write.