Abstract
Three patients were studied to determine the changes in regional skin temperature and blood flow during extensive sympathetic blockade following total spinal anaesthesia (TSA). Skin temperature was measured at the right upper arm, the right anterior chest at the nipple level, the right hand and the foot, using infrared thermography. Skin blood flow of the right upper arm (C6 area) was measured with a laser Doppler flowmeter. The temperature of the truncal area, arm and leg decreased by 1°C following TSA, whereas the temperature of the hand and foot increased by 3°C. The mean blood flow in three patients decreased to 26.1, 61.4, 51.7% of the control values 15 min after TSA. Our results indicate that extensive sympathetic nervous blockade during total spinal anaesthesia induces regional different changes in skin temperature and decrease in truncal skin blood flow.
Résumé
Trois patients ont été étudiés afin de déterminer les changements régionaux de la température cutanée et du débit sanguin, lors d’un bloc sympathique étendu, suite à une anesthésie sousarachnoïdienne totale (TSA). La température a été mesurée à différentes sites, à l’aide de la thermographie à infrarouge: le bras droit supérieur, la surface antérieure droite du thorax au niveau du mamelon, ainsi que la main et le pied droits. Le débit sanguin cutané du bras droit supérieur (dermatome C6) a été mesuré à l’aide d’un débitmètre au lazer et utilisant le Doppler. La température de la surface thoracique, du bras et de la jambe a diminué de 1°C suite à la TSA, alors que la température de la main et du pied a augmenté de 3° C. Le débit sanguin moyen chez les trois patientys a diminué de 26,1, 61,4 et 51,7% des valeurs de contrôle quinze minutes après la TSA. Nos résultats indiquent qu’un bloc nerveux sympathique étendu lors d’une anesthésie sousarachnoïdienne totale provoque des changements régionaux différents au niveau de la température cutanée et dimine le débit sanguin cutané thoracique.
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Kimura, T., Goda, Y., Kemmotsu, O. et al. Regional differences in skin blood flow and temperature during total spinal anaesthesia. Can J Anaesth 39, 123–127 (1992). https://doi.org/10.1007/BF03008641
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DOI: https://doi.org/10.1007/BF03008641