| Temperature Changes in Hands and Feet during and after T3 Sympathicotomy for Palmar Hyperhidrosis. |
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Tae Yop Kim, In Cheol Choi, Joon Hyong Park, Ji Yeon Sim, So Young Lee, Myung Won Cho, Seung Il Park |
1Department of Anesthesiology, Masan Samsung Hospital, School of Medicine, Sungkyunkwan University, Masan, Korea.
2Department of Anesthesiology, College of Medicine, University of Ulsan, Seoul, Korea.
3Department of Thoracic & Cardiovascular Surgery, College of Medicine, University of Ulsan, Seoul, Korea. |
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| Abstract |
BACKGROUND
Recently a report was published about the cross-inhibitory effect of post ganglionic neuron between upper extremities. We tried to find the existence of the same effect in all extremities by comparing the changes of skin temperature (ST) of all extremities during and after sympathicotomy for palmar hyperhidrosis.
METHODS
Twenty patients with palmar hyperhydrosis underwent bilateral video-assisted thoracoscopic sympathicomy. Right side T3 sympathicotomy was performed first, then left side T3 sympathicotomy was done. The ST of both hands and feet were compared with the ST before the surgery at 2, 4, 6, 10 minutes after first (right) sympathicotomy, 10 minutes after second (left) sympathicotomy and 4 hours after both sympathicotomy in the post anesthetic care unit (PACU) of our one-day surgery center.
RESULTS
At 10 minutes after completion of first (right) sympathicotomy, ipsilateral increase of the ST (right hand, 2.73 +/- 2.01oC) and contralateral decrease of the ST (left hand, - 0.65 +/- 0.88oC) were observed (P < 0.05). After the second (left) sympathicotomy was done, the ST of both feet decreased (right, - 1.24 +/- 0.81oC and left, - 1.31+/- 0.77oC, P < 0.05) and the ST of both hands increased (right, 3.34 +/- 2.40oC and left, 2.11+/- 1.91oC, P < 0.05). There were increases of the ST in both hands (right, 4.93 +/- 2.51oC and left, 4.63 +/- 2.19oC) and decreases of the ST in both feet (right, - 3.38 +/- 1.85oC and left, - 3.09 +/- 2.03oC, P < 0.05) in the PACU.
CONCLUSIONS
There may be a cross-inhibitory effect by the post ganglionic neurons innervating the blood vessels of the all extremities. Sympathicotomy causes the relief of the cross-inhibitory effect and result in vasoconstriction and a decrease of ST of contralateral hand and both feet. |
| Key Words:
Monitoring, Mtemperature; Surgery, sympathicotomy; Sympathetic nervous system, hyperhidrosis |
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