Digital skin bloodflow of patient rested on different positions--a laser Doppler study

Brachial plexus injuries resulting from malposition of the patient during general anesthesia have been described in the medical literature for nearly a century. However, concerning the brachial vessels which were accompanying the nervous plexus, few papers can be found discussing the changes that also occur when malpositing. In this study, an attempt was made to measure changes of digital skin bloodflow among patients resting in different postures simulating the operating postures in orthopaedic surgery. Laser doppler was found to be a sensitive indicator of skin bloodflow and peripheral vascular diseases. The results show that axillary pad used with patients resting in decubital positions does not change digital skin bloodflow or elbow flexion which could serve to reduce nervous tension among those patients whose digital skin bloodflow remains unchanged by hyperabductive shoulder positions. These findings do not support the preferred shoulder positions which are suggested in most papers discussing brachial plexus. From this it may be concluded that digital bloodflow is not occluded in healthy persons either by body postures or by the positions of the shoulders and elbows.