Korean J Anesthesiol.  2000 Feb;38(2):296-300. 10.4097/kjae.2000.38.2.296.

Comparison of T2 Sympathetic Block Effects on Blood Pressure and Heart Rate by Clipping and Sympathicotomy

Affiliations
  • 1Departments of Anesthesiology, Yongdong Severance Hospital.
  • 2Departments of Chest Surgery, Yongdong Severance Hospital.
  • 3Department of Statistics, Korea University.

Abstract

BACKGROUND: Thoracoscopic sympathicotomy was, at first, thought to be a simple and safe method for treatment of hyperhydrosis. However, the main disadvantage of this procedure is irreversibility in additions so-called rebound sweating occurred in 30 40% of patients during the first 1 2 weeks after operation. Some patients regret the surgery, even to the extend of preferring the original sweaty hands. Recently clipping has been suggested one of the way to minimize such problem. Hypothesis of this study was that sympathetic nerve block effect by clipping may be weak compared to sympathicotomy. The aim of this study was to evaluate and compare the sympathicotomy by clipping effect on cardiovascular system.
METHODS
Sixty-five patients with essential hyperhydrosis in ASA physical status class 1 undergoing thoracoscopic sympathetic block were randomly divided into two groups: The Clipping group (N = 21) and the sympathicotomy (N = 44) group. Anesthesia was induced with thiopental sodium (5 mg/kg) and pancuronium (0.05 mg/kg) and maintained with enflurane. The operation was done to the left side first and the to the right by an experienced surgeon. During the procedure, we measured blood pressure using a non invasive technique at the right forearm, heart rate and temperature after anesthetic induction as baseline values, immediately after the left side resection of the T2 sympathetic trunk or clipping, and after completely both sides resection. All the records were coded and analysed single blind by one author.
RESULTS
After the T2 sympathicotomy, heart rate decreased from 87 +/- 14 to 76 +/- 17 (P < 0.05) and the mean blood pressure was reduced from 77 +/- 14 to 64 +/- 10 mmHg (P < 0.05). After T2 clipping, heart rate decrease from 88 +/- 18 to 73 +/- 14 (P < 0.05) and mean blood pressure was reduced from 74 +/- 12 to 67 +/- 13 mmHg (P < 0.05).
CONCLUSION
The main result of this study was that there was no significant difference in sympathetic block effects on blood pressure and heart rate between clipping and sympathicotomy during the procedure.

Keyword

Autonomic nerve system: clipping; thoracic sympathicotomy

MeSH Terms

Anesthesia
Autonomic Nerve Block
Blood Pressure*
Cardiovascular System
Enflurane
Forearm
Hand
Heart Rate*
Heart*
Humans
Pancuronium
Sweat
Sweating
Thiopental
Enflurane
Pancuronium
Thiopental
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