Changes in the Autonomic Function after Thoracic Sympathicotomy by Clipping

Abstract

Background: A thoracic sympathicotomy with cauterization has been reported to decrease cardiac sympathetic activity. The purpose of this study was to investigate immediate changes in autonomic function after thoracic sympathicotomy by clipping.Methods: Autonomic function test such as heart rate response to deep breathing (HRDB), Valsalva ratio (VR), 30/15 ratio and systolic blood pressure change response to standing (△SBP) were measured before (baseline) and 2 hr after the T3-4 sympathicotomy by clipping in 12 patients with palmar hyperhidrosis. Baseline data were also compared with data obtained from 18 matched patients who were planned to take minor surgery. Anesthesia was induced with 5 mg/kg thiopental sodium and 0.6 mg/kg rocuronium. The anesthesia was maintained with 2.0-2.5 vol% sevoflurane, 2 L/min nitrous oxide and 2 L/min oxygen.Results: There were no significant differences of the autonomic test results between control and clip group before operation. In the clip group, there were no significant differences of autonomic test results between before and after clipping.Conclusions: This study showed that the response to sympathetic stimulation was not changed after thoracic sympathicotomy by clipping.

A pilot study on the role of autonomic function testing in predicting hypotension in patients undergoing cesarean section under spinal anesthesia

“…This activity is greater in women with Anesth Pain Med Vol. 14 gestational hypertension. Unlike sympathetic activity, women experiencing normal pregnancy experience lower levels of peripheral vascular resistance than those who are not pregnant.…”

“…Sympathetic functions were evaluated by observing DBP changes during a hand grip test and SBP changes after standing up. Tests were performed in order to observe HR changes during deep breathing, DBP changes during a handgrip test, and HR and blood pressure changes after standing up [14,15].…”

“…Parasympathetic functions were evaluated by testing HR changes while taking a deep breath and after standing up. The Valsalva maneuver was not performed to avoid fetal hypoxia [14,15]. Patients rested for 10 min in a supine position between tests.…”