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.