Evaluation of a new alpha-blocking vasodilator agent (thymoxamine) in peripheral vascular disease

The anaesthetic management of patients undergoing free flap transfer

The anaesthetic management of patients undergoing free flap transfer is discussed in the light of experience over a 4-year period. There is no single magical factor responsible for the success of this type of operation. But as the whole team has gained experience over the last 6 years, the incidence of vessel spasm and/or occlusion has been greatly reduced and at present is rare. It is therefore unusual for our patients to return to the operating theatre for re-exploration of the free flap that has developed ischaemia.

Evaluation of oral thymoxamine in patients with peripheral vascular occlusion of the lower limbs

To determine the effectiveness of oral thymoxamine (Opilon) as a cutaneous vasodilator in patients with peripheral vascular occlusion of the lower limb, double-blind trials of a placebo, of tolazoline in a dose of 50 mg., and of thymoxamine in single doses of 20, 40, 60, 80, and 100 mg. have been undertaken using skin temperature and skin blood-flow as measures of response. Thymoxamine produced no significant increases in skin temperature and blood-flow at any dose level, whereas in the same patients tolazoline produced highly significant increases.