2002
Effect of axillary brachial plexus blockade on baroreflex-induced skin vasomotor responses: Assessing the effectiveness of sympathetic blockade
Publication
Publication
Acta Anaesthesiologica Scandinavica: an international journal of anaesthesiology and intensive care, pain and emergency medicine , Volume 46 - Issue 7 p. 815- 820
Background: The combination of laser Doppler flowmetry and non-invasive blood pressure monitoring allows the continuous observation of cutaneous vascular resistance (CVR). Continuous recording of unmodulated skin blood flow (SBF) is very sensitive to artefacts, rendering the method unreliable. In contrast, intermittent short lasting challenges of the CVR by cardiovascular autonomic reflexes may provide information about the responsiveness of the sympathetic nervous system in the skin. Methods: Eleven patients with below-wrist hand surgery (six males and five females; aged 35.2 ± 7.1 years) performed Valsalva maneuver following axillary blockade. Skin blood flow was continuously monitored on the forearm of the side axillary blockade, as well as on the contra-lateral forearm, which was used as the control. The responses were expressed as changes compared with the baseline level derived from a resting period of 30s. The maximal change in CVR was determined during the late strain phase of the Valsalva maneuver on both sides. For numerical comparison the change in CVR on the axillary blockade and control sides were simultaneously calculated. Results: During the Valsalva maneuver a significant increase in CVR was observed on the control side with a maximum value during the late strain phase (baseline 0.18 ± 0.1 and late strain phase 0.42 ± 0.2 relative units; P < 0.01). In contrast, only minimal changes were detected on the side of axillary blockade in CVR (baseline 0.17 ± 0.8 and late stmin 0.16 ± 0.2 relative units; P=NS). Conclusions: Our findings support the disputed hypothesis that the human skin microvasculature is involved in baroreflex regulation under thermoneutral conditions. The determination of baroreflex stimulus-induced microvascular responses may serve as a feasible method for monitoring the effectiveness of sympathetic blockade.
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| doi.org/10.1034/j.1399-6576.2002.460710.x, hdl.handle.net/1765/73252 | |
| Acta Anaesthesiologica Scandinavica: an international journal of anaesthesiology and intensive care, pain and emergency medicine | |
| Organisation | Department of Cardiology |
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Szili-Török, T., Paprika, D., Peto, Z., Babik, B., Bari, F., Barzo, P., & Rudas, L. (2002). Effect of axillary brachial plexus blockade on baroreflex-induced skin vasomotor responses: Assessing the effectiveness of sympathetic blockade. Acta Anaesthesiologica Scandinavica: an international journal of anaesthesiology and intensive care, pain and emergency medicine, 46(7), 815–820. doi:10.1034/j.1399-6576.2002.460710.x |
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