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Anaesthesia 2019 & Surgery and Transplantation 2019: Pleth varibility index based intraoperative fluid management in head and neck free flap reconstructive surgeries

Itee Chowdhury D A

Background: Head and neck reconstructive surgeries involving microvascular free tissue transfer (free flap) poses a major challenge in achieving a good cosmetic and functional outcome. Intraoperative fluid administration may be animportant determining factor for a successful outcome. Static parameters like central venous pressure, mean arterial pressures, heart rate measurements for intraoperative fluid administration may not be reliable. Pleth varibility index (PVI) is a dynamic non-invasive parameter for intraoperative fluid administration and can easily be obtained by pulse co-oximeter derived value. PVI enables goal directed tailor maid fluid administration preventing fluid overload thuspreventing possible tissue oedema, thrombus formation and flap failure.