Local Nervous Mechanism in Regulation of Blood Flow in Human Subcutaneous Tissue

Abstract

The effect of local venous stasis upon blood flow in human subcutaneous adipose tissue on the distal part of the forearm was investigated in three healthy subjects and two chronically sympathectomized patients suffering from manual hyperhidrosis. The area under study was separated into two parts by means of a lead shield exerting a pressure of about 360 mmHg on the skin. The effect of venous stasis of about 40 mmHg on one side of the shield upon blood flow measured simultaneously on both sides of the shield by the local 133Xenon washout technique was investigated. During venous stasis on one side of the shield, blood flow decreased about 40% on both sides. The vasoconstrictor impulse could be transmitted over a distance of about 1-2 cm. The phenomenon was unaffected by nerve blockade induced 3 cm proximally, medially, and laterally to the area by infiltration the skin with lidocaine. Thus a vasoconstrictor impulse could be transmitted from the side of stasis to the non stasis side of the lead shield. The transmission was not affected by phentolamine but was blocked by lidocaine and chronic sympathetic denervation. The vasoconstrictor impulse elicited during venous stasis is therefore most likely transmitted by means of a local nervous mechanism involving sympathetic adrenergic vasoconstrictor fibres.