Hand, forearm and arm transplants require anesthetic management to address protocol and procedure-specific considerations related to regional blocks, effects of immunosuppressive drugs, fluid and hemodynamic management and rigorous intraoperative monitoring during procedures.
The study outlined salient aspects of upper extremity transplant anesthesia with five patients. It highlighted the importance of minimizing intraoperative vasopressors and improving fluid management and blood product use.
The results showed the approach reducing perioperative bleeding requiring re-exploration or hemostasis and shortened in-hospital and intensive care unit stay. Functional, immunologic and graft survival outcomes were encouraging in all five patients.
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