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Anaesthetic implications for transthoracic endoscopic sympathectomy
R Hartrey1, K R Poskitt, B P Heather
1Department of Anaesthesia, Cheltenham General Hospital, England.
The European Journal of Surgery. Supplement. : = Acta Chirurgica. Supplement
|January 1, 1994
Summary
Transthoracic endoscopic sympathectomy for hyperhidrosis is effective but requires careful anesthetic management. With skilled care and monitoring, this procedure can be performed safely, despite common transient complications like hypoxemia.
Area of Science:
- Thoracic surgery
- Anesthesiology
- Pulmonology
Background:
- Transthoracic endoscopic sympathectomy is the preferred treatment for upper limb hyperhidrosis.
- The procedure necessitates one-lung anesthesia, posing potential anesthetic challenges.
Purpose of the Study:
- To evaluate the anesthetic technique and peri-operative safety of transthoracic endoscopic sympathectomy.
- To identify and assess the incidence of complications associated with this procedure.
Main Methods:
- Retrospective review of anesthetic management and peri-operative complications in 26 patients.
- Continuous monitoring of vital signs including pulse, ECG, blood pressure, pulse oximetry, end-tidal CO2, and peak inspiratory pressure.
Main Results:
- Hypoxemia was a common but generally transient complication.
- Transient hypotension occurred, and two patients developed pneumothorax requiring pleural drainage.
- One case of persistent hypoxemia necessitated lung re-expansion.
Conclusions:
- Transthoracic endoscopic sympathectomy can be performed safely in patients with hyperhidrosis.
- Adequate patient monitoring and skilled anesthetic personnel are crucial for managing potential complications.
- The benefits of sympathectomy for hyperhidrosis outweigh the risks when managed appropriately.