Bosselmann, Talia and Kolbenschlag, Jonas and Goertz, Ole and Zahn, Peter and Prantl, Lukas and Lehnhardt, Marcus and Behr, Bjorn and Sogorski, Alexander (2021) Improvement of Superficial and Deep Cutaneous Microcirculation Due to Axillary Plexus Anesthesia Impaired by Smoking. JOURNAL OF CLINICAL MEDICINE, 10 (10): 2114. ISSN , 2077-0383
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Background: Understanding microvascular physiology is key to any reconstructive procedure. Current concepts in anesthesia increasingly involve regional peripheral nerve blockade during microvascular reconstructive procedures. Whereas favorable effects on perfusion due to these techniques have been reported earlier, little evidence focusing on its effects in most peripheral vascular compartments is available. Methods: A total of 30 patients who were to receive axillary plexus blockade (APB) were included. Microcirculatory assessment of the dependent extremity was conducted utilizing combined laser-Doppler flowmetry and white light spectroscopy. Two probes (1-2 and 7-8 mm penetration depth) were used to assess changes in microcirculation. Results: APB resulted in significant changes to both superficial and deep cutaneous microcirculation. Changes in blood flow were most prominent in superficial layers with a maximum increase of +617% compared to baseline values. Significantly lower values of +292% were observed in deep measurements. Consecutively, a significant enhancement in tissue oxygen saturation was observed. Further analysis revealed a significant impairment of perfusion characteristics due to reported nicotine consumption (max Bf: +936% vs. +176%). Conclusion: Cutaneous microcirculation is strongly affected by APB, with significant differences regarding microvascular anatomy and vascular physiology. Smoking significantly diminishes the elicited improvements in perfusion. Our findings could influence reconstructive strategies as well as dependent perioperative anesthetic management.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | HUMAN DERMAL MICROCIRCULATION; BLOOD-FLOW; EPIDURAL-ANESTHESIA; FREE FLAPS; SKIN; ULTRASTRUCTURE; VASODILATION; RESPONSES; BLOCKADE; NERVES; microcirculation; cutaneous perfusion; axillary plexus anesthesia; regional anesthesia; reconstructive microsurgery; smoking |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Plastische-, Hand- und Wiederherstellungschirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 12 Sep 2022 12:05 |
| Last Modified: | 12 Sep 2022 12:05 |
| URI: | https://pred.uni-regensburg.de/id/eprint/47209 |
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