Improvement of Superficial and Deep Cutaneous Microcirculation Due to Axillary Plexus Anesthesia Impaired by Smoking

URN to cite this document:

urn:nbn:de:bvb:355-epub-462373 Copy

DOI to cite this document:

10.5283/epub.46237 Copy

Bosselmann, Talia ; Kolbenschlag, Jonas ; Goertz, Ole ; Zahn, Peter ; Prantl, Lukas ; Lehnhardt, Marcus ; Behr, Björn ; Sogorski, Alexander

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Date of publication of this fulltext: 29 Jun 2021 16:09

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Details

Item type:	Article
Journal or Publication Title:	Journal of Clinical Medicine
Publisher:	MDPI
Volume:	10
Number of Issue or Book Chapter:	10
Page Range:	p. 2114
Date:	14 May 2021
Institutions:	Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Plastische-, Hand- und Wiederherstellungschirurgie
Projects:	Open Access Publizieren (DFG), Georgius Agricola Foundation Ruhr, grant from the “Junior Clinician Scientist” program by the FoRUM-program from the medical faculty of the Ruhr-University Bochum
Identification Number:	Value Type 10.3390/jcm10102114 DOI
Keywords:	microcirculation; cutaneous perfusion; axillary plexus anesthesia; regional anesthesia; reconstructive microsurgery; smoking
Dewey Decimal Classification:	600 Technology > 610 Medical sciences Medicine
Status:	Published
Refereed:	Yes, this version has been refereed
Created at the University of Regensburg:	Yes
Item ID:	46237

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Abstract

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 ...

Abstract

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.

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Metadata last modified: 29 Sep 2021 07:42

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