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

Monday, June 9, 2008

Sympathectomy incompatible with life

Danielopolu later declared cervicothoracic sympathectomy to be disastrous, from the therapeutic point of view, and concluded that removal of the stellate ganglion for angina was incompatible with life.
Landmarks in Cardiac Surgery
By Stephen Westaby, Cecil Bosher

Published 1998
Informa Health Care
Heart
683 pages
ISBN:1899066543

Complications in Cardiothoracic Surgery: Avoidance and Treatment

The most common complications of sympathectomy are related to manipulation of the autonomic nervous system.
By Alex G. Little
Published 2004
Blackwell Publishing
Prevention & control
464 pages
ISBN:0879934271

Neurophysiological Basis of Cerebral Blood Flow

In contras, the CM-Pf elicited cerebrovasodilation is shown to be, in part dependent on the integrite of the sympathetic innervation arising from the SCG (Mraovitch et al., 1986).
After ipsilateral sympathectomy, the CP-Pf-elicited rCBF was significantly reduced on the denervated side. For example, in the frontal cortex CM-Pf stimulation increased rCBF up to 130+-11ml/100g/min. Following sympathectomy the CM-Pf elicited increase was only 102+-4ml/100g/min.
The mechanism by which acute sympathectomy coupled to the CM-Pf stimulation reduces elevated cortical blood flow remains to be elucidated.

Effects of cervical sympathectomy on secondary vasodilation

Following unilateral transection of the cervical sympathetic trunk, the DMRF stimulation increased CBF bilaterally in all brain regions. In the cortical regions (frontal and parietal cortices) and in the caudate nucleus, the increase in CBF was slightly but significantly higher in the denervated side. Thus, the DMRF elicited cerebrovascular dilation is in part dependent on sympathetic excitation. However, the finding that the DMRF elicited cortical and caudate cerebrovasodilation following blockade of nerve traffic through the SCG increases in magnitude is in opposition to the finding that sympathectomy coupled to the DMRF stimulation decreased CBF responses. The reasons for this discrepancy is presently unknown.
Neurophysiological Basis of Cerebral Blood Flow
By Mraovtich, Sima Mraovitch, Richard Sercombe
Published 1996
John Libbey Eurotext
Cerebral circulation
424 pages
ISBN:0861962729

THE EFFECT OF SYMPATHECTOMY ON THE FATTY DEPOSIT IN CONNECTIVE TISSUE

A. B. L. Beznák 1 and Z. Hasch 1

1 The Institute of Experimental Pathology, University of Budapest

1. Unilateral section of both splanchnic nerves in cats diminishes the degree of fall in the amount of perirenal fat which follows laparotomy under ether anæsthesia. On the splanchnicotomised side the perirenal fat weighs 100-300 per cent. more than on the intact side.

2. The same difference is found if the cats starve after splanchnicotomy, or if cats with very little perirenal fat are fattened after the splanchnicotomy.

3. When cats are fed with a diet containing fat stained with Sudan III. the stained fat is deposited in the perirenal fat on both sides in equal concentrations. When they are starved after unilateral splanchnicotomy, the amount of the perirenal fatty tissue on the ipsilateral side is greater than on the normal. The concentration of Sudan III., however, remains on both sides the same as it was previous to the splanchnicotomy and starvation.

4. If cats and rats are kept on normal unstained diets for various periods after unilateral splanchnicotomy, are then fed with a diet containing fat stained with Sudan III. and are killed 18 hours after the feeding, the concentration of Sudan III. on the splanchnicotomised side is about of that on the normal side.

5. The conclusion is reached that, in consequence of the splanchnicotomy, changes take place in the perirenal connective tissue which slow both the deposition of fat and its mobilisation. The mobilisation is retarded more than the deposition.

Serum dopamine- -hydroxylase: decrease after chemical sympathectomy.

R Weinshilboum
J Axelrod

Dopamine-beta- hydroxylase is an enzyme that is localized to catecholamine-containing vesicles in sympathetic nerves and the adrenal medulla, and is also found in the serum. Treatment of rats with 6-hydroxydopamine, a drug which destroys sympathetic nerve terminals, leads to a decrease in serum dopamine-beta-hydroxylase activity. The decrease is not due to an effect on the adrenal medulla or to an increase in circulating inhibitor or inhibitors of enzyme. These data represent evidence that at least a portion of the circulating dopamine-beta-hydroxylase activity arises from sympathetic nerve terminals.

Sympathectomy and the immue system

In rodents, chemical sympathectomy attenuates primary
splenic antibody responses to systemic immunisation and lymph-node antibody responses to footpad challenge, suppresses cytotoxic T-cell responses to allogeneic cells, and reduces delayed-type hypersensitivity reactions; it is also associated with an enhancement of in-vivo lymphoproliferation in some lymph nodes and an increase in natural killer (NK) cell activity.'[ 11, 12] Chemical sympathectomy also increases the severity of experimental allergic encephalomyelitis[ 13] and adjuvant-induced arthritis in susceptible strains of rats. [ 14]
Psychoneuroimmunology: Interactions between the nervous system and the immune system.

Source: Lancet, 1/14/95, Vol. 345 Issue 8942, p99, 5p,

Author(s): Ader, Robert; Cohen, Nicholas

Cerebral venous blood oxygen content and brain blood flow

Cerebral venous blood oxygen content and brain blood flow

In both groups of patients the internal jugular blood oxygen concentration was reduced significantly from the recumbent value (p < 0.01). Comparable increases in the cerebral arteriovenous oxygen differences were observed. The increase in this oxygen difference after three minutes of tilt was significant in the patients studied after sympathectomy (p < 0.02), but was not in the pa- tients with essential hypertension. The decreases in the -oxygen content of cerebral venous blood after 20 minutes of tilt cannot be attributed to significant reductions in cerebral blood flow in either
group.

Cerebral oxygen consumption

Although the cerebral arteriovenous oxygen difference increased only 10% in the hypertensives, the 9% increase in cerebral oxygen consumption after 20 minutes of tilt proved to be highly significant (p < 0.01). Cerebral oxygen con- sumption was not increased in the postsympathetomy group.
Cerebrovascular resistance

The cerebral blood flow of the patients after sympathectomy was decreased 1 1% with a 26% reduction in "effective" mean cerebral pressure.
This can be explained by the fact that the cerebrovascular resistance decreased 17%o from 2.3 to 1.9 units, indicating a highly significant relaxation of cerebral vessels during the tilt period. A comparable reduction in cerebrovascular resistatice
was found both in the hypertensive patients and in the normotensive subjects.

By JOSEPH H. HAFKENSCHIEL, CHARLES W. CRUMPTON,2 HENRY A.
SHENKIN, JOHN H. MOYER,3 HAROLD A. ZINTEL, HERBERT
WENDEL,4 AND WILLIAM A. JEFFERS, WITH THE TECHNICAL
ASSISTANCE OF SALLY CONLIN HARNED, NELLYJ. KEFFER, AND GERALDINE CROFT

Sympathectomy-induced increases in calcitonin gene-related peptide (CGRP)-, substance P- and vasoactive intestinal peptide (VIP)-levels

The neuropeptide contents of rat salivary glands were increased four weeks after sympathetic postganglionic denervation (but not after preganglionic denervation): calcitonin gene-related peptide (CGRP) by 400 and 65% in the parotid and submandibular glands, respectively; substance P by 30% in the submandibular gland; and vasoactive intestinal peptide (VIP) by 30% in the parotid gland. The sensory neurotoxin capsaicin prevented the expected increases of CGRP and substance P in the submandibular glands and of VIP in the parotid glands. The CGRP-increase in the parotid gland was, however, only reduced (by 65%). Parasympathetic otic ganglionectomy reduced the peptide levels in the parotid glands (CGRP – 50%, VIP – 98% and substance P – 99%). From these residual levels, CGRP increased almost 8-fold and substance P 3-fold in response to the sympathetic denervation, while VIP was unaffected. In the parasympathetically denervated glands, the capsaicin-sensitive contribution to the CGRP-response to sympathetic denervation was roughly estimated to be more than 25% but less than 40%, while the corresponding contribution to the substance P-response was roughly estimated to be more than 6% but less than 58%. Most likely not only CGRP/substance P-containing sensory C-fibres (submandibular and parotid glands) but also parasympathetic VIP-containing secretomotor and vasomotor fibres (parotid glands) contributed to the capsaicin-sensitive response to sympathetic denervation.
J. Ekströma R. Ekman
2005

altering Ca2+ activity of actomyosin ATPase

Also, Sympathectomy may impair cardiac functional capacity by altering Ca2+ activity of actomyosin ATPase.

Effects of thyroid deficiency and sympathectomy on cardiac enzymes

K. M. Baldwin, P. J. Campbell, A. M. Hooker and R. E. Lewis
AJP - Cell Physiology, Vol 236, Issue 1 30-C34, Copyright © 1979
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