Postoperative depth of sedation and associated outcomes in free flap transfers to the head and neck.

Abstract

To evaluate the impact of postoperative depth of sedation in free flap transfers to the head and neck. A single center, retrospective cohort of 92 patients were stratified by depth of sedation, light sedation (RASS -1 or greater) or deep sedation (RASS less than -1), and analyzed for postoperative flap and medical complications. Of the 92 patients 45 were included in the light sedation and 47 in the deep sedation group. Flap complication requiring return to the operating room occurred in 8 (22.2%) patients in light sedation compared to 12 (27.7%) (p=0.450) patients in deep sedation. A composite outcome of flap and medical complications occurred less frequently in the light sedation group 14 (31.8%) compared to deep sedation 32 (69.6%) (p < 0.001). There was no difference in return to the operating room between the two groups. Light sedation had reduced incidence of medical complications compared to deep.