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

Thursday, June 12, 2008

15.2% drop in ejection fraction

The study was approved by the local ethics committee, and in agreement with the Helsinki II declaration written informed consent was obtained in each case. Healthy (ASA I) patients scheduled for thoracoscopic sympathectomy for flushing syndrome were asked to participate in the study, and all patients were evaluated for presence of cardiac disease prior to anaesthesia.

Fourteen participants (12 f; 2 m) with a median age of 32.5 (range: 26–70) yr were successively enrolled in the study. All participants were unmedicated and had no history of previous cardiac illness. Preoperative cardiac risk assessment, including ECG and chest X-ray, revealed no evidence of manifest cardiac disease.
Transthoracic TDE image acquisition and subsequent analysis was possible in all participants. Full TTS from apical four- and two-chamber views was not possible in four of 14 individuals, mainly due to poor signal/noise ratio in apical segments.
Propofol anaesthesia induction resulted in significant attenuation in blood pressure but no change in HR was observed (Table 1). TDE variables (PSV, TTD, and TTS) declined significantly, whereas TTP was unchanged (Table 1).

Limitations of the current study: As the primary objective was to evaluate LV function by measuring myocardial velocities, no LV area calculations were performed. TTS was attempted in order to form the basis for comparison with currently used methods. As noted, TTS was not possible in some patients; however, the results from 10 patients were conclusive (15.2% drop in ejection fraction) (P = 0.009). Similarly, as the study population consisted of healthy patients undergoing short-duration minor surgery no invasive pressures were coupled with TDE.

Propofol reduces tissue-Doppler markers of left ventricle function: a transthoracic echocardiographic study

J. R. Larsen1,2,*, P. Torp1, K. Norrild1 and E. Sloth1
1 Department of Anaesthesiology and Intensive Care
2 Department of Experimental and Clinical Research, Skejby Sygehus, Aarhus University Hospital, DK-8200 Aarhus N, Denmark

Symptoms became worse after bilateral sympathectomy

In an attempt to control his hypertension, bilateral syrnpathectomy was performed in 1968. Following this procedure, the patient's hypertension improved, but his symptoms exacerbated. His lassitude and dyspnea on exertion increased and, in addition, he had frequent episodes of angina pectoris. He also complained of severe palpitations and dizziness during physical activity. It is noteworthy that following the initial episode of chest pain in 1984, the patient had been free of any form of chest discomfort until after the sympathectomy.

The history of this patient seems particularly noteworthy in that his symptoms became worse after bilateral sympathectomy and subsequent improvement in the control of his hypertension. When the blood pressure became lower, the dyspnea on exertion worsened, angina pectoris appeared and dizziness on physical activity was noted for the first time.
DOI 10.1378/chest.57.1.87 1970;57;87-90
Chest
Eduardo Moreyra, Pieter Knibbe and Albert N. Brest
Hypertension and Muscular Subaortic Stenosis

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