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Cold hypersensitivity after sympathectomy for Raynaud's disease
Scandinavian Journal of Thoracic and Cardiovascular Surgery
|January 1, 1980
Summary
Bilateral upper thoracic sympathectomy for Raynaud's disease can paradoxically cause cold hypersensitivity rebound. This rebound effect persisted in one patient despite proven nerve degeneration, indicating unpredictable outcomes after surgery.
Area of Science:
- Vascular Surgery
- Neurology
- Symptom Management
Background:
- Raynaud's disease is a condition causing blood vessel spasms in extremities, often triggered by cold.
- Surgical sympathectomy aims to alleviate symptoms by interrupting sympathetic nerve signals.
- Bilateral upper thoracic sympathectomy is a surgical option for severe Raynaud's disease.
Observation:
- Two patients with severe Raynaud's disease underwent bilateral upper thoracic sympathectomy.
- Both patients experienced a rebound hypersensitivity to cold within days of the surgery.
- This cold hypersensitivity persisted in one patient post-operation.
Findings:
- Complete degeneration of vasoconstrictor fibers was confirmed in the persistent case.
- The sympathetic veno-arteriolar reflex was absent, indicating successful nerve fiber destruction.
- Pre-operative sympathetic blockade did not predict the post-operative rebound phenomenon.
Implications:
- Surgical sympathectomy outcomes for Raynaud's disease can be unpredictable.
- Rebound cold hypersensitivity may occur even after successful nerve degeneration.
- Further research is needed to understand and predict post-sympathectomy complications.