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In pigs, latissimus dorsi musculocutaneous island flaps and buttock skin island flaps were raised. Subcutaneous (PscO2) and intramuscular oxygen tension (PimO2) were measured using a non-heated needle electrode before, during and after repeated occlusion of the supplying artery or the draining vein. During arterial and venous occlusion, the tissue oxygen tension in the musculocutaneous flap dropped rapidly. A plateau was reached after 15 min. After arterial occlusion the mean value was 20 mmHg (SEM = +/- 5 mmHg, N = 6) in the subcutis and 16 mmHg in the muscle (SEM = +/- 4 mmHg, N = 10). After venous occlusion the mean value was 11 mmHg (SEM = +/- 3 mmHg, N = 6) in the subcutis. In the skin flap the drop of PscO2 was slower, and after 30 min of arterial occlusion the mean value was 29 mmHg (SEM = +/- 9 mmHg, N = 6). This study has shown that tissue oxygen tension measurement can be used as a sensitive indicator of acute impairment of the supplying vessels in island flaps. The method seems to have potential for monitoring free tissue transfers. A comparable decrease in PscO2 was found for arterial and venous impairment.

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We studied the hemodynamic response to preoperative emptying of the stomach by means of a gastric tube in 20 non-fasting non-premedicated patients aged 39 (24-54) (median and quartiles) presenting for emergency surgery. Systolic and diastolic blood pressure and heart rate increased by 24.4% (P less than 0.01), 29.9% (P less than 0.01) and 36% (P less than 0.01), respectively. Arterial oxygen saturation decreased by 2.1% (P less than 0.01). The rate pressure product increased by 68% (P less than 0.01), exceeding 20,000 (mmHg.min-1) [2667 kPa.min-1] in nine patients. The cardiovascular response is of the same magnitude as reported after tracheal intubation without use of analgesics and is likely to cause cardiac ischemia and other adverse effects in patients suffering from coronary artery disease.

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