Effects of skin blood flow and temperature on skin--electrode impedance and offset potential: measurements at low alternating current density.

Skin--electrode impedance was determined at 100 Hz and 1 kHz between two disposable electrodes, 5 cm apart, at current densities < 65 microA.cm-2. Measurements were made on the volar skin of the forearm during cooling on cardiopulmonary bypass, and on the dorsum of the foot in the absence of skin blood flow during aortic aneurysm repair. Both the resistive and reactive components of the skin-electrode impedence showed an inverse linear relationship to temperature between 26 and 36 degrees C. The magnitude of the impedance change was different for each patient studied; resistance changes ranged from 0.03 to 23.2 k omega. Degrees C-1 at 100 Hz and from 0.03 to 2.7 k omega. Degrees C-1 at 1 kHz, while reactance changes ranged from 0.4 to 2.1 k omega. Degrees C-1 at 100 Hz and from 0.04 to 0.18 k omega. Degrees C-1 at 1 kHz. Changes in skin-electrode impedance were not due to changes in skin blood flow. There was no consistent change in offset potential with temperature. Although the skin-electrode impedance increases as temperature falls, it is concluded that temperature effects at the skin-electrode interface are not responsible for the observed failure of evoked electromyography during clinical monitoring of neuromuscular function.