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Topical anaesthesia does not affect cutaneous vasomotor or sudomotor responses in human skin

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The effects of local sensory blockade (topical anaesthesia) on eccrine sweat glands and cutaneous circulation are not well understood. This study aimed to determine whether topical lidocaine/prilocaine alters eccrine sweat gland and cutaneous blood vessel responses. Sweating (capacitance hygrometry) was induced via forearm intradermal microdialysis of five acetylcholine (ACh) doses (1 × 10−4 to 1 × 100 m, 10‐fold increments) in control and treated forearm sites in six healthy subjects. Nitric oxide‐mediated vasodilatory (sodium nitroprusside) and adrenergic vasoconstrictor (noradrenaline) agonists were iontophoresed in lidocaine/prilocaine‐treated and control forearm skin in nine healthy subjects during blood flow assessment (laser Doppler flowmetry, expressed as% from baseline cutaneous vascular conductance; CVC; flux/mean arterial pressure). Non‐linear regression curve fitting identified no change in the ED50 of ACh‐induced sweating after sensory blockade (−1.42 ± 0.23 logM) compared to control (−1.27 ± 0.23 logM; P > .05) or in E max (0.43 ± 0.08 with, 0.53 ± 0.16 mg cm−2 min−1 without lidocaine/prilocaine; P > .05). Sensory blockade did not alter the vasodilator response to sodium nitroprusside (1280 ± 548% change from baseline CVC with, 1204 ± 247% without lidocaine/prilocaine) or vasoconstrictor response to noradrenaline (−14 ± 4% change from baseline CVC with, −22 ± 14% without lidocaine/prilocaine; P > 0.05). Cutaneous sensory blockade does not appear to alter nitric oxide‐mediated vasodilation, adrenergic vasoconstriction, or cholinergic eccrine sweating dose‐response sensitivity or responsiveness to maximal dose. Thus, lidocaine/prilocaine treatment should not affect sweat gland function or have blood flow implications for subsequent research protocols or clinical procedures.
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Document Type: Research Article

Publication date: October 1, 2013

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