Skip Navigation



BJA Advance Access published online on December 4, 2008
British Journal of Anaesthesia, doi:10.1093/bja/aen349
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
102/2/205    most recent
aen349v1
Right arrow E-Letters: Submit a response to the article
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Beed, M.
Right arrow Articles by Moppett, I. K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Beed, M.
Right arrow Articles by Moppett, I. K.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Transient hyperaemic response to assess skin vascular reactivity: effects of heat and iontophoresed norepinephrine

M. Beed1, M. B. O'Connor1, J. Kaur2, R. P. Mahajan1,3 and I. K. Moppett1,3,*

1 Department of Anaesthesia, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK
2 Department of Anaesthesia, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, UK
3 Division of Anaesthesia and Intensive Care, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, UK

* Corresponding author. E-mail: iain.moppett{at}nottingham.ac.uk

Background: Forearm skin vascular reactivity may be assessed using a transient hyperaemic response (THR) after 20 s of brachial artery compression. THR has been manipulated by iontophoresis of vasodilators, but not vasoconstrictors, possibly because of low baseline blood flow. The effects of vasoconstrictors on vascular reactivity of pre-dilated blood vessels are unknown. We have investigated this using locally applied heat to vasodilate the skin microcirculation before iontophoresis of norepinephrine.

Methods: Active and control laser Doppler probes measured forearm skin blood flow-flux. Three THR tests were performed before and after heating skin for 5 min, and then after iontophoresis of norepinephrine 0.1%. Iontophoresis was pulsed using 45 s periods of 75 µA and 0 current over 10 min. Three temperatures were used: unheated skin, skin at 35°C, and skin at 42°C. Baseline flow-flux was measured for 60 s before each set of THR tests. THR ratio (THRR) was calculated by comparing baseline flow-flux immediately before arterial compression (F1) with the maximum after release (F2): THRR=F2/F1. The average values of each group of THRR results, and baseline data, were compared using the Kruskal–Wallis test.

Results: Iontophoresis of norepinephrine caused significant decreases in flow-flux (P<0.005). Unheated skin and skin heated to 35°C showed significant decreases in THRR after norepinephrine. THRR was abolished by heating to 42°C and partially restored by iontophoresis of norepinephrine.

Conclusions: Iontophoresed norepinephrine causes vasoconstriction, and it partially restores vascular reactivity in the heat-induced vasodilated skin. This may be of benefit when norepinephrine is used in clinical situations.

Keywords: blood, flow; blood, flow, forearm; blood, flow, skin; sympathetic nervous system; sympathetic nervous system, norepinephrine


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.