Anesthesia of the conditioned limb does not abolish the remote ischemic conditioning stimulus on cutaneous microcirculation in humans.
Remote ischemic conditioning
microsurgery
neuronal signaling
plexus anesthesia
reperfusion
Journal
Clinical hemorheology and microcirculation
ISSN: 1875-8622
Titre abrégé: Clin Hemorheol Microcirc
Pays: Netherlands
ID NLM: 9709206
Informations de publication
Date de publication:
2020
2020
Historique:
pubmed:
20
7
2019
medline:
3
7
2020
entrez:
20
7
2019
Statut:
ppublish
Résumé
Mechanism of remote ischemic conditioning (RIC) remain not fully understood yet. Thus, a clinical trial was performed to assess the neuronal influence on its signal induction. RIC was conducted on 45 patients who were randomized into 3 groups. Group A and B underwent brachial plexus anesthesia while RIC was performed on the blocked (A) and non-blocked side (B), respectively. In group C, RIC was conducted before regional anesthesia, thus serving as control group. All measurements were taken contralateral to RIC. The relative increase of microcirculatory parameters compared to baseline was evaluated and compared between the groups. Superficial blood flow (sBF) significantly increased in group A and C but values were higher among group C. Compared to group A, group C showed a significant increase of sBF during the initial 5 minutes of reperfusion (1.75; CI 1.139 - 2.361 vs. 0.97, CI 0.864 - 1.076, p < 0.05). Deep blood flow, tissue oxygen saturation and relative hemoglobin content were marginally influenced by RIC irrespectively of the presence of regional anesthesia. Despite regional anesthesia a significant RIC stimulus can be induced although its microcirculatory response is attenuated compared to control. Hence, RIC induction does not merely depend on neuronal signaling.
Sections du résumé
BACKGROUND
BACKGROUND
Mechanism of remote ischemic conditioning (RIC) remain not fully understood yet. Thus, a clinical trial was performed to assess the neuronal influence on its signal induction.
METHODS
METHODS
RIC was conducted on 45 patients who were randomized into 3 groups. Group A and B underwent brachial plexus anesthesia while RIC was performed on the blocked (A) and non-blocked side (B), respectively. In group C, RIC was conducted before regional anesthesia, thus serving as control group. All measurements were taken contralateral to RIC. The relative increase of microcirculatory parameters compared to baseline was evaluated and compared between the groups.
RESULTS
RESULTS
Superficial blood flow (sBF) significantly increased in group A and C but values were higher among group C. Compared to group A, group C showed a significant increase of sBF during the initial 5 minutes of reperfusion (1.75; CI 1.139 - 2.361 vs. 0.97, CI 0.864 - 1.076, p < 0.05). Deep blood flow, tissue oxygen saturation and relative hemoglobin content were marginally influenced by RIC irrespectively of the presence of regional anesthesia.
CONCLUSION
CONCLUSIONS
Despite regional anesthesia a significant RIC stimulus can be induced although its microcirculatory response is attenuated compared to control. Hence, RIC induction does not merely depend on neuronal signaling.
Identifiants
pubmed: 31322552
pii: CH190626
doi: 10.3233/CH-190626
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM