Does bilateral thoracic sympathectomy predispose to reflex bronchospasm following tracheal intubation?

Patients with essential hyperhidrosis have sympathetic overactivity, associated with compensatory high parasympathetic tone. Sympathectomy results in a decrease of plasma norepinephrine,³ and parasympathetic predominance4 which may increase airway resistance.⁵ Intraoperative bronchospasm is usually cholinergically-mediated. Thus, patients with essential hyperhidrosis who have undergone bilateral thoracic sympathectomy, may be more liable to develop reflex bronchospasm under light levels of anesthesia.
Ahed Zeidan, MD^*, Nazih Nahle, MD^* and Anis Baraka, MD FRCA
Canadian Journal of Anesthesia 52:997-998 (2005)
© Canadian Anesthesiologists' Society, 2005