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Related Concept Videos

Autonomic Nervous System01:22

Autonomic Nervous System

The autonomic nervous system (ANS) is a critical component of the peripheral nervous system, primarily responsible for regulating involuntary bodily functions and maintaining homeostasis. It functions in tandem with the central nervous system (CNS) to seamlessly coordinate various physiological processes without the need for conscious control.
The ANS comprises two main divisions: the sympathetic and parasympathetic divisions. These divisions function antagonistically to maintain a dynamic...
Sympathetic Activation01:16

Sympathetic Activation

The sympathetic division can influence tissues and organs by releasing norepinephrine at peripheral synapses and distributing epinephrine and norepinephrine through the bloodstream. In times of crisis or stress, sympathetic activation occurs, which is regulated by sympathetic centers in the hypothalamus. As a result, sympathetic activation prepares the body for physical exertion, rapid ATP production, and heightened alertness, allowing individuals to respond effectively to challenging or...
Parasympathetic Division of the ANS01:08

Parasympathetic Division of the ANS

The parasympathetic division of the autonomic nervous system (ANS) regulates rest and digestion functions in the body. It works in opposition to the sympathetic division, promoting relaxation, conservation of energy, and digestion. The parasympathetic division consists of preganglionic fibers originating from specific cranial nerves (III, VII, IX, X) and the sacral spinal nerves (S2-S4). These fibers synapse with postganglionic neurons in the terminal ganglia, innervating various organs and...
Sympathetic Signaling01:31

Sympathetic Signaling

Sympathetic signaling, a vital part of the autonomic nervous system, plays a crucial role in mobilizing the body's resources in response to stress or emergencies. It involves the transmission of nerve impulses from sympathetic preganglionic fibers to postganglionic fibers. This results in the release of specific neurotransmitters and activation of adrenergic receptors.
Sympathetic preganglionic fibers release the neurotransmitter acetylcholine (ACh) onto the ganglionic neurons in the...
Adrenergic Agonists: Therapeutic Uses01:30

Adrenergic Agonists: Therapeutic Uses

Adrenergic agonists have diverse therapeutic uses across various medical conditions and emergencies.
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and anaphylaxis:...
Endoscopic Studies II: Thoracocentesis01:26

Endoscopic Studies II: Thoracocentesis

Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...

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Targeting Gray Rami Communicantes in Selective Chemical Lumbar Sympathectomy
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Autonomic function following endoscopic thoracic sympathotomy for hyperhidrosis.

John E Schmidt1, Erica A Wehrwein, Lynn A Gronbach

  • 1Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.

Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society
|August 12, 2010
PubMed
Summary

Endoscopic thoracic sympathotomy (ETS) for hyperhidrosis normalizes cardiac autonomic function, shifting heart rate variability (HRV) towards control levels. This minimally invasive procedure effectively modulates exaggerated sympathetic control without impacting blood pressure regulation.

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Area of Science:

  • Cardiovascular Physiology
  • Autonomic Nervous System Function
  • Surgical Outcomes

Background:

  • Primary palmar-plantar hyperhidrosis is excessive sweating of hands and feet.
  • Endoscopic thoracic sympathotomy (ETS) disconnects thoracic sympathetic nerves to treat refractory hyperhidrosis.
  • ETS aims to minimize compensatory hyperhidrosis by sparing specific ganglia.

Purpose of the Study:

  • To evaluate the impact of ETS on cardiac autonomic function in hyperhidrosis patients.
  • To assess changes in heart rate variability (HRV) and baroreflex sensitivity post-ETS.
  • To compare post-ETS autonomic function with pre-operative states and healthy controls.

Main Methods:

  • 22 hyperhidrosis patients underwent ETS, with 17 followed up 1-12 months post-surgery.
  • Heart rate and blood pressure were measured at rest and during modified Oxford infusion.
  • Heart rate variability indices (RMSSD, LF, HF) and baroreflex sensitivity were calculated.

Main Results:

  • Resting heart rate tended to decrease post-ETS.
  • Significant changes in HRV included increased HF (nu) and decreased LF (nu, log) power.
  • Post-surgery HRV indices became similar to matched controls, unlike pre-surgery.
  • No significant changes were observed in baroreflex sensitivity or QTc interval.

Conclusions:

  • ETS effectively alters cardiac autonomic modulation of heart rate towards normal levels.
  • Observed HRV changes align with blunted sympathetic control in hyperhidrosis patients post-ETS.
  • ETS does not significantly impair blood pressure regulation, as indicated by stable baroreflex indices.