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Subcutaneous blood flow in man during sleep with continuous epidural anaesthesia
J H Sindrup1, L J Petersen, J Kastrup
1Department of Clinical Physiology, Bispebjerg Hospital, Denmark.
Background:
Subcutaneous blood flow increases during sleep and we evaluated if this increase is affected by epidural anaesthesia.
Methods:
Lower leg subcutaneous blood flow was determined by 133Xenon clearance in ten subjects during continuous epidural anaesthesia at L2-L3 including eight hours of sleep, while the upper abdominal subcutaneous blood flow served as control.
Results:
Epidural anaesthesia to the level of the umbilicus was followed by an increase in the lower leg subcutaneous blood flow from 3.4 (1.8-6.3) to 7.8 (3.6-16.9) ml min-1 100 g-1 (median and range; P < 0.001) and returned to 3.5 (2.4-7.6) ml min-1 100 g-1 after 88 (45-123) min. In contrast, until the period of sleep the upper abdominal region blood flow remained at 5.2 (3.2-6.4) ml min-1 100 g-1. During sleep, lower leg subcutaneous blood flow did not change significantly, but the upper abdominal flow increased to 6.2 (5.2-7.2) ml min-1 100 g-1 after 34 (29-70) min (P < 0.01), and it remained elevated for 125 (100-164) min.
Conclusions:
The results indicate that although epidural anaesthesia induced only a temporary increase in lower leg subcutaneous blood flow, it hindered the rise in subcutaneous blood flow normally manifest during early sleep.