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神经阻滞对身体加热和冷却期间前臂及手指皮肤血流的影响。

The effect of nerve blockade on forearm and finger skin blood flow during body heating and cooling.

作者信息

Saumet J L, Degoute C S, Saumet M, Abraham P

机构信息

Laboratoire de Physiologie et d'Explorations Vasculaires, C.H.R.U., Angers, France.

出版信息

Int J Microcirc Clin Exp. 1992 Aug;11(3):231-40.

PMID:1506128
Abstract

To determine the role of the active cutaneous vasodilatator response in forearm and finger skin, direct assessment of only skin blood flow was performed before and after musculocutaneous and median nerve blockade during whole body heating and cooling. Forearm laser Doppler flow (LDF forearm), forearm heat thermal clearance (HTC forearm), and finger laser Doppler flow (LDF finger) were monitored in the nerve blocked skin and contralateral untreated skin (control). In the pre-blockade period, no significant differences were found between experimental and control arm skin. After nerve block a significant increase occurred only in LDF finger, which rose from 4.3 +/- 0.6 to 6.0 +/- 0.5 volts (p less than 0.05). During whole body heating LDF forearm and HTC forearm increased significantly on both arms. The increase in LDF forearm was greater (p less than 0.05) in control (18.3 +/- 1.2 volts) than in nerve blocked skin (14.6 +/- 1.8 volts) and occurred earlier. The same tendency was observed in HTC forearm between nerve blocked skin (0.522 +/- 0.06 W.m-1.degrees C-1) and control 0.671 +/- 0.037 W.m-1.degrees C-1) (NS). LDF raise up to 6.6 +/- 0.5 and 6.8 +/- 0.5 volts in the blocked finger and in the control respectively. During cooling LDF finger in the control decreased to 1.3 +/- 0.1 volt and was significantly (p less than 0.05) lower than in the resting period, and lower than that in the nerve blocked finger (3.4 +/- 0.8 volts) (p less than 0.05). We conclude that the active vasodilatator system plays an important role as far as the timing and the amplitude of the cutaneous vasodilatator response to whole body heating in the forearm but not in the finger. At thermal neutrality, the vascular vasoconstrictor tone is high to the finger but not to the forearm. The vasoconstrictor response to cooling occurred only in the finger.

摘要

为了确定前臂和手指皮肤中活跃的皮肤血管舒张反应的作用,在全身加热和冷却过程中,在肌皮神经和正中神经阻滞前后,仅对皮肤血流进行了直接评估。在前臂激光多普勒血流(LDF前臂)、前臂热清除率(HTC前臂)和手指激光多普勒血流(LDF手指)在神经阻滞皮肤和对侧未处理皮肤(对照)中进行了监测。在阻滞前阶段,实验手臂皮肤和对照手臂皮肤之间未发现显著差异。神经阻滞后,仅LDF手指显著增加,从4.3±0.6伏升至6.0±0.5伏(p<0.05)。在全身加热期间,双臂的LDF前臂和HTC前臂均显著增加。对照(18.3±1.2伏)中LDF前臂的增加幅度大于神经阻滞皮肤(14.6±1.8伏)(p<0.05),且出现得更早。在神经阻滞皮肤(0.522±0.06W·m-1·℃-1)和对照(0.671±0.037W·m-1·℃-1)之间的HTC前臂也观察到相同趋势(无显著性差异)。阻滞手指和对照手指的LDF分别升高至6.6±0.5伏和6.8±0.5伏。在冷却期间,对照中的LDF手指降至1.3±0.1伏,显著低于静息期(p<0.05),且低于神经阻滞手指(3.4±0.8伏)(p<0.05)。我们得出结论,就前臂皮肤对全身加热的血管舒张反应的时间和幅度而言,活跃的血管舒张系统起着重要作用,但对手指则不然。在热中性状态下,手指的血管收缩张力较高,而前臂则不然。血管收缩反应仅在手指中出现。

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