Assessment of sympathetic nerve activity in the practice of lumbar sympatholysis: interest of sympathetic skin responses

Lefaucheur, Jean‐Pascal; Becquemin, Jean‐Pierre; Brugières, Pierre; Verroust, J

doi:10.1016/0165-1838(96)00035-5

Cited by 13 publications

(5 citation statements)

References 22 publications

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“…In spite of a battery of autonomic function tests available, there is no gold standard for sympathetic function testing in the limbs. The best available test is the sympathetic skin response test (SSR), which can quantify the degree of sympathetic activity present 1–3 but requires sophisticated equipment and dedicated personnel. The starch–iodine test has long been suggested as a simple bedside test, but is messy and of unproven reliability.…”

Section: Introductionmentioning

confidence: 99%

Skin Wrinkling for the Assessment of Sympathetic Function in the Limbs

Vasudevan

Rij

Nukada

et al. 2000

Aust. N.Z. J. Surg.

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Section: Introductionmentioning

confidence: 99%

Skin Wrinkling for the Assessment of Sympathetic Function in the Limbs

Vasudevan

Rij

Nukada

et al. 2000

Aust. N.Z. J. Surg.

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“…Various measurements for verifying successful LSGB have been introduced, such as a sweat test, sympathogalvanic response, thermography, plethysmography, and laser Doppler flowmetry. 3 – 6 , 19 These tests, however, are not readily available to clinicians because they are resource-intensive and result in additional medical costs to the patients as well as additional time for interpretion. Monitoring the changes in skin temperature is another method for evaluating sympathetic block.…”

Section: Discussionmentioning

confidence: 99%

“… 2 After an LSGB attempt, the success of the procedure can be assessed using various tests, such as skin conductance response, sweat tests, thermography, plethysmography, and laser Doppler. 3 – 6 These tests, however, may be impractical in a clinical setting because they are resource-intensive and require a time delay for interpretion. Clinically, ipsilateral foot temperature measurement is the most commonly used, effective technique because the temperature at the acral region of the body is largely dependent on blood flow, which is well correlated with changes in skin temperature.…”

Section: Introductionmentioning

confidence: 99%

Change in pulse transit time in the lower extremity after lumbar sympathetic ganglion block: an early indicator of successful block

et al. 2017

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ObjectiveTo investigate the change in pulse transit time (PTT)—time between the electrocardiographic R wave and the highest point of the corresponding plethysmographic wave—after lumbar sympathetic ganglion block (LSGB) and evaluate PTT as an indicator of successful LSGB.MethodsSixteen cases of sympathetically mediated lower extremity neuropathic pain treated with LSGB were studied. Correlations between the changes in PTT and temperature were used to identify the cutoff point indicating successful LSGB.ResultsPTT rate of change at 5 min relative to the baseline PTT (dPTT5/PTT0) significantly correlated positively with the temperature change at 20 min (correlation coefficient 0.734). The dPTT5/PTT0 ratios of the Success and Failure groups were 6.46 ± 2.81% and 2.77 ± 1.72%, respectively. The dPTT5/PTT0 cutoff indicating successful LSGB, based on receiver operating characteristic curve analysis, was 4.23%.ConclusionPTT measurement 5 min after local anesthetic injection was an early, objective indicator of successful or failed LSGB.

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“…The SSR was tested with the same NATUS Dantec Keypoint 2.32 machine used for neurography 20 , 21 . The test was performed with the patient lying in a quiet warm room.…”

Section: Methodsmentioning

confidence: 99%

Parasympathetic autonomic dysfunction is more often evidenced than sympathetic autonomic dysfunction in fluctuating and polymorphic symptoms of "long-COVID" patients

Zanin

Amah

Chakroun

et al. 2023

Sci Rep

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Several disabling symptoms potentially related to dysautonomia have been reported in “long-COVID” patients. Unfortunately, these symptoms are often nonspecific, and autonomic nervous system explorations are rarely performed in these patients. This study aimed to evaluate prospectively a cohort of long-COVID patients presenting severe disabling and non-relapsing symptoms of potential dysautonomia and to identify sensitive tests. Autonomic function was assessed by clinical examination, the Schirmer test; sudomotor evaluation, orthostatic blood pressure (BP) variation, 24-h ambulatory BP monitoring for sympathetic evaluation, and heart rate variation during orthostatism, deep breathing and Valsalva maneuvers for parasympathetic evaluation. Test results were considered abnormal if they reached the lower thresholds defined in publications and in our department. We also compared mean values for autonomic function tests between patients and age-matched controls. Sixteen patients (median age 37 years [31–43 years], 15 women) were included in this study and referred 14.5 months (median) [12.0–16.5 months] after initial infection. Nine had at least one positive SARS-CoV-2 RT-PCR or serology result. Symptoms after SARS-CoV-2 infection were severe, fluctuating and disabling with effort intolerance. Six patients (37.5%) had one or several abnormal test results, affecting the parasympathetic cardiac function in five of them (31%). Mean Valsalva score was significantly lower in patients than in controls. In this cohort of severely disabled long-COVID patients, 37.5% of them had at least one abnormal test result showing a possible contribution of dysautonomia to these nonspecific symptoms. Interestingly, mean values of the Valsalva test were significantly lower in patients than in control subjects, suggesting that normal values thresholds might not be appropriate in this population.

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Assessment of sympathetic nerve activity in the practice of lumbar sympatholysis: interest of sympathetic skin responses

Cited by 13 publications

References 22 publications

Skin Wrinkling for the Assessment of Sympathetic Function in the Limbs

Skin Wrinkling for the Assessment of Sympathetic Function in the Limbs

Change in pulse transit time in the lower extremity after lumbar sympathetic ganglion block: an early indicator of successful block

Parasympathetic autonomic dysfunction is more often evidenced than sympathetic autonomic dysfunction in fluctuating and polymorphic symptoms of "long-COVID" patients

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