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Anesthesia for Free Flap Reconstruction after Head and Neck Surgical Resection

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Oncologic Critical Care

Abstract

The purpose of this chapter is to examine current data related to anesthetic management for oncology patients undergoing free flap reconstruction after surgical resection. Due to case complexity, radiotherapy history, patient comorbidities, and increased incidence of difficult airway, head and neck reconstruction surgeries often pose numerous challenges to the anesthesia care team. Anesthesia and surgery for head and neck reconstruction often result in a shared airway situation. It is paramount to have clear communication among all perioperative team members and establish a pre-planned strategy for airway management. Significant tobacco and alcohol use, environmental exposures, and transmission of human papilloma virus are significant risk factors for the development of head and neck cancers. Of these cancers, the vast majority present as squamous cell carcinomas. Underlying cardiovascular and pulmonary disease, post-radiation fibrosis, electrolyte abnormalities, and dehydration are commonplace in this patient population. Case management must include a proper approach to advanced airway management and optimization of patient condition while maintaining ideal conditions for successful free flap reconstruction.

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Author information

Authors and Affiliations

  1. Division of Anesthesiology, Critical Care and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Jennifer Jones

  2. Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Faisal I. Ahmad

Authors
  1. Jennifer Jones
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  2. Faisal I. Ahmad
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Corresponding author

Correspondence to Jennifer Jones .

Editor information

Editors and Affiliations

  1. Department of Critical Care, University of Texas MD Anderson Cancer C Department of Critical Care, Houston, TX, USA

    Joseph L. Nates

  2. Department of Critical Care, University of Texas MD Anderson Cancer C Department of Critical Care, Houston, TX, USA

    Kristen J. Price

Section Editor information

  1. Department of Anesthesiology Division of Anesthesia, Critical Care and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Garry Brydges DNP, MBA, CRNA, ACNP-BC, FAAN

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Jones, J., Ahmad, F.I. (2019). Anesthesia for Free Flap Reconstruction after Head and Neck Surgical Resection. In: Nates, J., Price, K. (eds) Oncologic Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-74698-2_158-1

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  • DOI: https://doi.org/10.1007/978-3-319-74698-2_158-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-74698-2

  • Online ISBN: 978-3-319-74698-2

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