Intraoperative Hyperlactatemia during Facial Gender Affirmation Surgery

Hyperlactatemia is defined as elevations in blood lactate >2 mmol above baseline without concurrent metabolic acidosis [1]. Prolonged hyperlactatemia can be an independent risk factor for worse outcomes as lactate is a byproduct of anaerobic metabolism and linked with tissue ischemia and/or organ dysfunction. In head and neck surgical patients, normalization of hyperlactatemia is crucial to decrease mortality and postoperative complications [2]. However, even in critically-ill surgical patients, hyperlactatemia is not necessarily indicative of circulatory failure [3]. Our center has anecdotally noted hyperlactatemia in patients undergoing Facial Gender-Affirmation Surgery (FGAS), but it remains unclear whether it corresponds directly to adverse clinical outcomes. The present study sought to examine implications of intraoperative hyperlactatemia during FGAS.