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Article

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

1
Center of Plastic, Aesthetic, Hand and Reconstructive Surgery, University Hospital of Regensburg, 93053 Regensburg, Germany
2
Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen, 72076 Tuebingen, Germany
3
Department of Plastic Surgery and Hand Surgery, Burn Center, BG Universitätsklinikum Bergmannsheil Bochum, Ruhr-University Bochum, 44789 Bochum, Germany
4
Department of Plastic, Reconstructive and Aesthetic Surgery, Hand Surgery, Martin-Luther-Hospital, 14193 Berlin, Germany
5
Department of Anesthesiology, Intensive Care Medicine, Palliative and Pain Medicine, BG Universitätsklinikum Bergmannsheil Bochum, Ruhr-University Bochum, 44789 Bochum, Germany
*
Author to whom correspondence should be addressed.
Academic Editor: Hirofumi Noguchi
J. Clin. Med. 2021, 10(10), 2114; https://doi.org/10.3390/jcm10102114
Received: 14 April 2021 / Revised: 3 May 2021 / Accepted: 10 May 2021 / Published: 14 May 2021
(This article belongs to the Special Issue Tissue Perfusion and Organ Regeneration)
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. View Full-Text
Keywords: microcirculation; cutaneous perfusion; axillary plexus anesthesia; regional anesthesia; reconstructive microsurgery; smoking microcirculation; cutaneous perfusion; axillary plexus anesthesia; regional anesthesia; reconstructive microsurgery; smoking
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MDPI and ACS Style

Bosselmann, T.; Kolbenschlag, J.; Goertz, O.; Zahn, P.; Prantl, L.; Lehnhardt, M.; Behr, B.; Sogorski, A. Improvement of Superficial and Deep Cutaneous Microcirculation Due to Axillary Plexus Anesthesia Impaired by Smoking. J. Clin. Med. 2021, 10, 2114. https://doi.org/10.3390/jcm10102114

AMA Style

Bosselmann T, Kolbenschlag J, Goertz O, Zahn P, Prantl L, Lehnhardt M, Behr B, Sogorski A. Improvement of Superficial and Deep Cutaneous Microcirculation Due to Axillary Plexus Anesthesia Impaired by Smoking. Journal of Clinical Medicine. 2021; 10(10):2114. https://doi.org/10.3390/jcm10102114

Chicago/Turabian Style

Bosselmann, Talia, Jonas Kolbenschlag, Ole Goertz, Peter Zahn, Lukas Prantl, Marcus Lehnhardt, Björn Behr, and Alexander Sogorski. 2021. "Improvement of Superficial and Deep Cutaneous Microcirculation Due to Axillary Plexus Anesthesia Impaired by Smoking" Journal of Clinical Medicine 10, no. 10: 2114. https://doi.org/10.3390/jcm10102114

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