The amount of compensatory sweating depends on the patient, the damage that the white rami communicans incurs, and the amount of cell body reorganization in the spinal cord after surgery.
Other potential complications include inadequate resection of the ganglia, gustatory sweating, pneumothorax, cardiac dysfunction, post-operative pain, and finally Horner’s syndrome secondary to resection of the stellate ganglion.
www.ubcmj.com/pdf/ubcmj_2_1_2010_24-29.pdf

After severing the cervical sympathetic trunk, the cells of the cervical sympathetic ganglion undergo transneuronic degeneration
After severing the sympathetic trunk, the cells of its origin undergo complete disintegration within a year.
http://onlinelibrary.wiley.com/doi/10.1111/j.1439-0442.1967.tb00255.x/abstract

Tuesday, April 22, 2008

A dysesthetic syndrome can occur after sympathectomy

Eugenia-Daniela Hord, MD, Instructor, Departments of Anesthesia and Neurology, Massachusetts General Hospital Pain Center, Harvard Medical School

A dysesthetic syndrome can occur after sympathectomy; it usually is transient but sometimes can be persistent.
Chemical sympathectomy is transient and should be used initially for diagnostic purposes to
establish the involvement of SNS and hence inhibition of sympathetic activity (eg, increased limb
temperature or ocular Horner signs) without evidence of sensory somatic blockade (eg,
hypoesthesia to pinprick and cold stimuli).

For chemical sympathectomy, 2 basic techniques are used.
Injections of local anesthetic around sympathetic paravertebral ganglia that project to the
affected body part (sympathetic ganglion block): This will affect all components of the
sympathetic outflow to an extremity (adrenergic vasoconstrictor, cholinergic sudomotor, and adrenergic pilomotor).

Intravenous regional block: This will prevent the release of only norepinephrine from the sympathetic terminals within the region of application (ie, distal to the tourniquet).