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Microvascular free flap surgery requires a delicate balance between optimum patient hemodynamic status andadequate free flap perfusion during the entire perioperative course. A potentially turbulent postoperative course must be appropriately averted as this can lead to flap failure. This paper presents the successful use of postoperative dexmedetomidine infusion to provide a smooth transition after discontinuing general anesthesia while maintaining free flap viability in a 19-year-old male with ameloblastoma who underwent hemimandibulectomy and free fibular osteomyocutaneous microvascular flap surgery.

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