Anesthesia for Free Flap Reconstruction After Head and Neck Surgical Resection

  • Jennifer JonesEmail author
  • Faisal I. Ahmad
Reference work entry


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.


Anesthesia Difficult intubation Fiber-optic intubation Difficult airway Oncology Head and neck reconstruction Free flap 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Division of Anesthesiology, Critical Care and Pain MedicineThe University of Texas MD Anderson Cancer CenterHoustonUSA
  2. 2.Department of Head and Neck SurgeryThe University of Texas MD Anderson Cancer CenterHoustonUSA

Section editors and affiliations

  • Garry Brydges
    • 1
  1. 1.Department of Anesthesiology Division of Anesthesia, Critical Care and Pain MedicineThe University of Texas MD Anderson Cancer CenterHoustonUSA

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