Effect of alkalimized mepivacaine for epidural anesthesia on the skin temperature and skin blood flow: A mathematical analysis by simulation model

The role of skin temperature in reflex control of the active cutaneous vasodilator system was examined in six subjects during mild graded heat stress imposed by perfusing water at 34, 36, 38, and 40°C through a tube-lined garment. Skin sympathetic nerve activity (SSNA) was recorded from the peroneal nerve with microneurography. While monitoring esophageal, mean skin, and local skin temperatures, we recorded skin blood flow at bretylium-treated and untreated skin sites by using laser-Doppler velocimetry and local sweat rate by using capacitance hygrometry on the dorsal foot. Cutaneous vascular conductance (CVC) was calculated by dividing skin blood flow by mean arterial pressure. Mild heat stress increased mean skin temperature by 0.2 or 0.3°C every stage, but esophageal and local skin temperature did not change during the first three stages. CVC at the bretylium tosylate-treated site (CVCBT) and sweat expulsion number increased at 38 and 40°C compared with 34°C ( P < 0.05); however, CVC at the untreated site did not change. SSNA increased at 40°C ( P < 0.05, different from 34°C). However, SSNA burst amplitude increased ( P < 0.05), whereas SSNA burst duration decreased ( P < 0.05), at the same time as we observed the increase in CVCBT and sweat expulsion number. These data support the hypothesis that the active vasodilator system is activated by changes in mean skin temperature, even at normal core temperature, and illustrate the intricate competition between active vasodilator and the vasoconstrictor system for control of skin blood flow during mild heat stress.

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Reflex control of skin blood flow by skin temperature: role of core temperature

Journal of Applied Physiology ◽

10.1152/jappl.1979.47.6.1188 ◽

1979 ◽

Vol 47 (6) ◽

pp. 1188-1193 ◽

Cited By ~ 43

Author(s):

J. M. Johnson ◽

M. K. Park

Keyword(s):

Blood Flow ◽

Skin Temperature ◽

Skin Blood Flow ◽

Work Load ◽

Reflex Response ◽

Esophageal Temperature ◽

Internal Temperature ◽

Reflex Control ◽

Different Levels

Two protocols were used to discover whether the reflex response in skin blood flow (SkBF) to rising skin temperature (Tsk) was dependent on the level of internal temperature. Part I. In five subjects, Tsk (controlled with water-perfused suits) was raised to 37 degrees C prior to, between 2 and 5 min, or between 10 and 17 min of exercise. The associated SkBF elevation per degree rise in Tsk averaged 0.20, 1.28, and 1.75 ml/100 ml . min, respectively. When Tsk was raised during the first 5 min of exercise, esophageal temperature (Tes) rose markedly (0.39 degrees C), but transiently fell if Tsk was raised after 10 min of exercise. Part II. In six subjects, different work loads were used to develop different levels of internal temperature. Tsk was elevated to 37 degrees C after 10--15 min at light (50--75 W) or moderate (100--150 W) work loads. At the heavier work load (and higher Tes), the rise in forearm SkBF per degree rise in Tsk averaged 2.33 +/- 0.38 (SE) times that observed at the light work load. These data strongly suggest that the reflex response of SkBF to rising Tsk is dependent on the level of internal temperature.

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Influence of electroacupuncture stimulation on skin temperature, skin blood flow, muscle blood volume and pupil diameter

Acupuncture in Medicine ◽

10.1136/acupmed-2017-011433 ◽

2019 ◽

Vol 38 (2) ◽

pp. 86-92

Author(s):

Tomoko Kubota ◽

Hidetoshi Mori ◽

Tateyuki Morisawa ◽

Kazuyo Hanyu ◽

Hiroshi Kuge ◽

...

Keyword(s):

Blood Flow ◽

Skin Temperature ◽

Blood Volume ◽

Skin Blood Flow ◽

Pupil Diameter ◽

Spinal Reflexes ◽

Control Group ◽

Acupuncture Points ◽

Tibialis Muscle ◽

Significant Difference

Objective: To examine the effect of electroacupuncture (EA) stimulation on multiple physiological indices and to evaluate both local and systemic physiological responses induced by the stimulation. Methods: 15 healthy male college students participated in an experimental crossover study. They received two kinds of interventions: one with EA stimulation and one without EA stimulation on different days. Two disposable acupuncture needles were inserted at two traditional acupuncture points (ST36 and ST38), located along the anterior tibialis muscle. EA stimulation was administered for 10 min. Skin temperature (ST), skin blood flow (SBF) and muscle blood volume (MBV) were recorded near the stimulation sites, while the pupil diameter (PD) was measured before, during and after the interventions. Results: ST, SBF and MBV increased significantly following EA stimulation. PD of the right and left eyes decreased significantly following EA stimulation. There was a significant difference in ST responses between the groups (P=0.001). For SBF, MBV and PD, no significant differences were demonstrated between the groups. Conclusions: Our study showed that 10 min of EA stimulation increased ST, SBF and MBV, and decreased PD, compared to baseline, while no significant change was observed in the control group. This suggests that EA stimulation alters local blood flow and ST, and these responses are likely mediated via segmental spinal reflexes, supraspinal reflexes involving parasympathetic activation, and other mechanisms.

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Orderly recruitment of thermoeffectors in resting humans

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.00324.2017 ◽

2018 ◽

Vol 314 (2) ◽

pp. R171-R180 ◽

Cited By ~ 12

Author(s):

Zachary J. Schlader ◽

James R. Sackett ◽

Suman Sarker ◽

Blair D. Johnson

Keyword(s):

Blood Flow ◽

Metabolic Rate ◽

Thermal Behavior ◽

Skin Temperature ◽

Skin Blood Flow ◽

Sweat Rate ◽

Flow Behavior ◽

Thermoregulatory Behavior ◽

Physiological Cost ◽

Heat And Cold Stress

The recruitment of thermoeffectors, including thermoregulatory behavior, relative to changes in body temperature has not been quantified in humans. We tested the hypothesis that changes in skin blood flow, behavior, and sweating or metabolic rate are initiated with increasing changes in mean skin temperature (Tskin) in resting humans. While wearing a water-perfused suit, 12 healthy young adults underwent heat (Heat) and cold stress (Cold) that induced gradual changes in Tskin. Subjects controlled the temperature of their dorsal neck to their perceived thermal comfort. Thus neck skin temperature provided an index of thermoregulatory behavior. Neck skin temperature (Tskin), core temperature (Tcore), metabolic rate, sweat rate, and nonglabrous skin blood flow were measured continually. Data were analyzed using segmental regression analysis, providing an index of thermoeffector activation relative to changes in Tskin. In Heat, increases in skin blood flow were observed with the smallest elevations in Tskin ( P < 0.01). Thermal behavior was initiated with an increase in Tskin of 2.4 ± 1.3°C (mean ± SD, P = 0.04), while sweating was observed with further elevations in Tskin (3.4 ± 0.5°C, P = 0.04), which coincided with increases in Tcore ( P = 0.98). In Cold, reductions in skin blood flow occurred with the smallest decrease in Tskin ( P < 0.01). Thermal behavior was initiated with a Tskin decrease of 1.5 ± 1.3°C, while metabolic rate ( P = 0.10) and Tcore ( P = 0.76) did not change throughout. These data indicate that autonomic and behavioral thermoeffectors are recruited in coordination with one another and likely in an orderly manner relative to the comparative physiological cost.

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Effect of Ultrafiltration on Thermal Variables, Skin Temperature, Skin Blood Flow, and Energy Expenditure during Ultrapure Hemodialysis

Journal of the American Society of Nephrology ◽

10.1681/asn.2004080655 ◽

2005 ◽

Vol 16 (6) ◽

pp. 1824-1831 ◽

Cited By ~ 25

Author(s):

Frank M. van der Sande ◽

Laura M. Rosales ◽

Zohar Brener ◽

Jeroen P. Kooman ◽

Martin Kuhlmann ◽

...

Keyword(s):

Blood Flow ◽

Energy Expenditure ◽

Skin Temperature ◽

Skin Blood Flow

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The sympathetic release test: a test used to assess thermoregulation and autonomic control of blood flow

AJP Advances in Physiology Education ◽

10.1152/advan.00095.2013 ◽

2014 ◽

Vol 38 (1) ◽

pp. 87-92 ◽

Cited By ~ 11

Author(s):

E. A. Tansey ◽

S. M. Roe ◽

C. D. Johnson

Keyword(s):

Blood Flow ◽

Skin Temperature ◽

Skin Blood Flow ◽

Whole Body ◽

Temperature Sensitive ◽

Typical Sample ◽

Release Test ◽

Sample Data ◽

The Subject ◽

Clinical Conditions

When a subject is heated, the stimulation of temperature-sensitive nerve endings in the skin, and the raising of the central body temperature, results in the reflex release of sympathetic vasoconstrictor tone in the skin of the extremities, causing a measurable temperature increase at the site of release. In the sympathetic release test, the subject is gently heated by placing the feet and calves in a commercially available foot warming pouch or immersing the feet and calves in warm water and wrapping the subject in blankets. Skin blood flow is estimated from measurements of skin temperature in the fingers. Normally skin temperature of the fingers is 65–75°F in cool conditions (environmental temperature: 59–68°F) and rises to 85–95°F during body heating. Deviations in this pattern may mean that there is abnormal sympathetic vasoconstrictor control of skin blood flow. Abnormal skin blood flow can substantially impair an individual's ability to thermoregulate and has important clinical implications. During whole body heating, the skin temperature from three different skin sites is monitored and oral temperature is monitored as an index of core temperature. Students determine the fingertip temperature at which the reflex release of sympathetic activity occurs and its maximal attainment, which reflects the vasodilating capacity of this cutaneous vascular bed. Students should interpret typical sample data for certain clinical conditions (Raynaud's disease, peripheral vascular disease, and postsympathectomy) and explain why there may be altered skin blood flow in these disorders.

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Differences in the postexercise threshold for cutaneous active vasodilation between men and women

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.00428.2005 ◽

2006 ◽

Vol 290 (1) ◽

pp. R172-R179 ◽

Cited By ~ 14

Author(s):

Glen P. Kenny ◽

Jane E. Murrin ◽

W. Shane Journeay ◽

Francis D. Reardon

Keyword(s):

Blood Flow ◽

Skin Temperature ◽

Skin Blood Flow ◽

Peak Oxygen Consumption ◽

Whole Body ◽

Mean Skin Temperature ◽

Local Skin ◽

Men And Women ◽

Cutaneous Vasodilation ◽

Vasodilatory Response

The purpose of this study was to evaluate the possible differences in the postexercise cutaneous vasodilatory response between men and women. Fourteen subjects (7 men and 7 women) of similar age, body composition, and fitness status remained seated resting for 15 min or cycled for 15 min at 70% of peak oxygen consumption followed by 15 min of seated recovery. Subjects then donned a liquid-conditioned suit. Mean skin temperature was clamped at ∼34°C for 15 min. Mean skin temperature was then increased at a rate of 4.3 ± 0.8°C/h while local skin temperature was clamped at 34°C. Skin blood flow was measured continuously at two forearm skin sites, one with (UT) and without (BT) (treated with bretylium tosylate) intact α-adrenergic vasoconstrictor activity. The exercise threshold for cutaneous vasodilation in women (37.51 ± 0.08°C and 37.58 ± 0.04°C for UT and BT, respectively) was greater than that measured in men (37.33 ± 0.06°C and 37.35 ± 0.06°C for UT and BT, respectively) ( P < 0.05). Core temperatures were similar to baseline before the start of whole body warming for all conditions. Postexercise heart rate (HR) for the men (77 ± 4 beats/min) and women (87 ± 6 beats/min) were elevated above baseline (61 ± 3 and 68 ± 4 beats/min for men and women, respectively), whereas mean arterial pressure (MAP) for the men (84 ± 3 mmHg) and women (79 ± 3 mmHg) was reduced from baseline (93 ± 3 and 93 ± 4 mmHg for men and women, respectively) ( P < 0.05). A greater increase in HR and a greater decrease in the MAP postexercise were noted in women ( P < 0.05). No differences in core temperature, HR, and MAP were measured in the no-exercise trial. The postexercise threshold for cutaneous vasodilation measured at the UT and BT sites for men (37.15 ± 0.03°C and 37.16 ± 0.04°C, respectively) and women (37.36 ± 0.05°C and 37.42 ± 0.03°C, respectively) were elevated above no exercise (36.94 ± 0.07°C and 36.97 ± 0.05°C for men and 36.99 ± 0.09°C and 37.03 ± 0.11°C for women for the UT and BT sites, respectively) ( P < 0.05). A difference in the magnitude of the thresholds was measured between women and men ( P < 0.05). We conclude that women have a greater postexercise onset threshold for cutaneous vasodilation than do men and that the primary mechanism influencing the difference between men and women in postexercise skin blood flow is likely the result of an altered active vasodilatory response and not an increase in adrenergic vasoconstrictor tone.

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Effect of changes in local skin temperature on postural vasoconstriction in man

Clinical Science ◽

10.1042/cs0740201 ◽

1988 ◽

Vol 74 (2) ◽

pp. 201-206 ◽

Cited By ~ 26

Author(s):

Ahmad A. K. Hassan ◽

J. E. Tooke

Keyword(s):

Blood Flow ◽

Skin Temperature ◽

Skin Blood Flow ◽

Arteriovenous Anastomoses ◽

Local Cooling ◽

Local Skin ◽

Hot Air ◽

Postural Changes ◽

Local Skin Temperature ◽

Heart Blood

1. The effects of locally induced alterations in skin temperature on the postural changes in skin blood flow of the foot were assessed in 38 healthy subjects in a constant-temperature environment (22 ± 0.5°C, mean ± sd). 2. Moderate local cooling and warming of the foot (26–36°C) was induced by blowing cold or hot air. Higher ranges of temperature (38–44°C) were achieved by a thermostatically controlled disc heater. 3. Skin blood flow was measured before and during each change in local skin temperature using a laser Doppler flowmeter with the foot maintained at heart level, and placed passively 50 cm below the heart. Blood flow was measured in two skin areas: (i) the dorsum of the foot, where arteriovenous anastomoses are absent, and (ii) the pulp of the big toe, where these anastomoses are relatively numerous. 4. It was found that within the physiological temperature range of 26–36°C the normal postural fall in foot skin blood flow was preserved, whereas it was markedly attenuated or totally abolished at higher temperatures (38–44°C). The pattern of response was quite similar in areas having or lacking arteriovenous anastomoses. 5. It is suggested that the failure of postural vasoconstriction observed at the higher skin temperatures might contribute to some of the problems of cardiovascular adaptations seen in a hot environment.

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