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外周神经阻滞对人体小腿皮下血流夜间波动无影响。

Lack of effect of peripheral nervous blockade on nocturnal fluctuations in lower-leg subcutaneous blood flow in man.

作者信息

Sindrup J H, Petersen L J, Kastrup J, Wroblewski H, Kristensen J K

机构信息

Department of Clinical Physiology/Nuclear Medicine, University of Copenhagen, Bispebjerg Hospital, Denmark.

出版信息

Clin Sci (Lond). 1993 Mar;84(3):297-304. doi: 10.1042/cs0840297.

DOI:10.1042/cs0840297
PMID:8384952
Abstract
  1. The local subcutaneous adipose tissue blood flow was measured simultaneously in the right and left lower legs of 10 normal human subjects under out-patient nocturnal conditions. The 133Xe-wash-out technique, portable CdTe(Cl) detectors and a portable data-storage unit were used for the measurement of blood flow. 2. The purpose of the study was to unveil the possible role of centrally controlled nerve fibres to the measurement area as mediators of a previously described nocturnal subcutaneous hyperaemia of 2 h duration. Therefore, before the sleeping period, a local nervous blockade was applied immediately proximal to the isotope depot on the right lower leg by the injection of approximately 15 ml of bupivacaine (5 mg/ml) subcutaneously. 3. Control experiments revealed blockade of the baroreceptor vasoconstrictor reflex activity 4 h after application of the local nervous blockade in three subjects examined. 4. Identical nocturnal isotope-wash-out curves were recorded from the two legs. Subcutaneous blood flow was found to increase significantly (P < 0.0001) after approximately 1 h of sleep and the hyperaemia persisted for 2 h. 5. A significant positive correlation was detected between the latency periods from going to bed until the onset of the hyperaemia in the right and left lower legs (P < 0.001, r = 0.95). 6. No significant difference could be detected between the relative blood flow increase during the hyperaemic phase in the right and left lower legs (P = 0.83). 7. It is concluded that the present data seem to rule out a central nervous factor(s) as the eliciting mechanism of the nocturnal subcutaneous hyperaemia.(ABSTRACT TRUNCATED AT 250 WORDS)
摘要
  1. 在门诊夜间条件下,对10名正常受试者的左右小腿同时测量局部皮下脂肪组织血流量。采用¹³³氙洗脱技术、便携式碲化镉(氯)探测器和便携式数据存储单元测量血流量。2. 本研究的目的是揭示中枢控制的神经纤维对测量区域的可能作用,作为先前描述的持续2小时夜间皮下充血的介质。因此,在睡眠期前,通过在右小腿同位素注射部位近端皮下注射约15 ml布比卡因(5 mg/ml),立即进行局部神经阻滞。3. 对照实验显示,在三名接受检查的受试者中,局部神经阻滞后4小时,压力感受器血管收缩反射活动被阻断。4. 两条腿记录到相同的夜间同位素洗脱曲线。发现睡眠约1小时后皮下血流量显著增加(P < 0.0001),充血持续2小时。5. 检测到从上床睡觉到左右小腿充血开始的潜伏期之间存在显著正相关(P < 0.001,r = 0.95)。6. 左右小腿充血期相对血流量增加之间未检测到显著差异(P = 0.83)。7. 得出结论,目前的数据似乎排除了中枢神经因素作为夜间皮下充血的引发机制。(摘要截短为250字)

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