The influence of ulnar nerve blockade on skin microvascular blood flow.
Microvascular research is seriously hampered by the great temporal and spatial variability of the measured skin blood flow and variation in sympathetic vasomotor reflexes within and between persons. Therefore skin vasomotor reflexes were studied before and after ulnar nerve blockade within the same person, resulting in a temporal complete denervation of the fifth finger and partial denervation of the fourth finger. Skin temperature and laser Doppler flux (LDF) were registrated to measure predominantly arteriovenous shuntflow. Measurements were performed on the palmar tip of the second and fifth finger in nine healthy volunteers, at baseline, and during a sympathetic reflex test (i.e. inspiratory gasp) and postural response test. Beat-to-beat digital blood pressure was recorded from the third and fourth finger by a Finapres device. Baseline capillary blood cell velocity (CBV) was measured at the nailfold of the second and the fifth finger. After ulnar blockade baseline skin temperature, LDF and CBV increased significantly, with respectively (mean +/- SE) 3.2 +/- 0.9 degrees C, 20.9 +/- 5.9 relative perfusion units and 0.79 +/- 0.40 mm-1 s. The percentage LDF decrease of the fifth finger during inspiratory gasp was 48.2 +/- 5.3% before and 3.1 +/- 0.9% after blockade. The postural response test showed a decrease in LDF of the fifth finger with no significant difference before and after blockade, respectively 12.3 +/- 14.7% and 8.0 +/- 2.7%, while no difference was found in the increase in digital blood pressure in the denervated fourth finger compared to both the same finger before blockade and to the third non-blocked finger.(ABSTRACT TRUNCATED AT 250 WORDS)
Netten
P M
PM
Department of Medicine, University Hospital Nijmegen, The Netherlands.
Wollersheim
H
H
Gielen
M J
MJ
Den Arend
J A
JA
Lutterman
J A
JA
Thien
T
T
D001783:Blood Flow Velocity / Q000187:drug effects; D001794:Blood Pressure; D005385:Fingers / Q000098:blood supply; D006801:Humans; D001239:Inhalation; D008012:Lidocaine / Q000494:pharmacology; D008833:Microcirculation / Q000502:physiology*; D011187:Posture; D012016:Reference Values; D012018:Reflex; D012039:Regional Blood Flow; D012867:Skin / Q000098:blood supply*; D013997:Time Factors; D014459:Ulnar Nerve / Q000187:drug effects / Q000502:physiology*; D018608:Ultrasonography, Doppler; D014661:Vasoconstriction
D008012:Lidocaine