Perioperative Anesthetic Considerations for Head and Neck Free Flap Reconstructions: A Narrative Review
Sasima Dusitkasem, MD¹, Thiothong Sirimusika, MD¹, Rojnarin Komonhirun, MEd¹
Affiliation : ¹ Department of Anesthesiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Microsurgical free flap reconstruction remains the primary standard of care for managing complex defects, following advanced head and neck cancer resections. Although success rates have improved substantially, these complex procedures represent a major challenge to achieve the optimum patient and flap outcomes. Recent advances in preoperative evaluation and anesthetic management focus on patient optimization and perioperative care to maximize free flap survival and reduce complications.
Received 30 June 2025 | Revised 6 January 2026 | Accepted 12 January 2026
DOI: 10.35755/jmedassocthai.2026.2.03222
Keywords : Head and neck surgery; Free flap reconstruction; Flap survival; Anesthesia management; Perioperative care
