Differential recovery of skeletal muscle and peripheral nerve function after ischemia and reperfusion

Recovery of skeletal muscle function is of prime importance in revascularization of acutely ischemic extremities. In order to study the effect of ischemia and reperfusion on peripheral nerve and skeletal muscle function, temporary unilateral hindlimb ischemia (1 or 3 hr) was induced in 12 rabbits by temporary arterial occlusion of common iliac and femoral arteries and collateral ligation. The control limb was similarly prepared without interruption of blood flow. Both anterior tibialis muscles were attached to force transducers, and the twitch and tetanic tensions were measured at the end of the ischemic interval and during reperfusion (2 hr) by either direct muscle stimulation or stimulation of the deep peroneal nerve. The ischemic limb was reperfused by removal of arterial clamps and reperfusion documented by Doppler flow over the vascular pedicle. The recovery of muscle function of the ischemic/reperfused limb relative to that of the contralateral control limb was used as the index of recovery. By the end of the ischemic interval, no contractile activity was elicited with nerve stimulation for either the 1- or the 3-hr group. After 2 hr of reperfusion, the 1-hr group regained 0.558 +/- 0.116 (mean +/- SEM) of control function with nerve stimulation, while the 3-hr group regained only 0.016 +/- 0.005 of control function (P less than 0.01). In contrast, with direct muscle stimulation, the 1-hr group produced 0.580 +/- 0.015 compared to 0.286 +/- 0.042 (P less than 0.001) after 3 hr of ischemia.(ABSTRACT TRUNCATED AT 250 WORDS)