Changes in Both Palmar Skin Temperature during Video Endoscopic Thoracic Sympathicotomy for Hyperhidrosis / 대한마취과학회지

BACKGROUND: Monitoring the skin temperature changes of the palm during video endoscopic thoracic sympathicotomy has been used as a measure of the success of the surgery. When general anesthesia is used during sympathicotomy, increases of skin temperature on the ipsilateral palm is less than that observed in percutaneous chemical sympathectomy. Contralateral skin temperature has been found to be decreased. So we measured palmar skin temperature on both sides during sympathicotomy to learn whether we can use it as a indicator of success under general anesthesia, and to see contralateral sympathetic responses. METHODS: Thirty patients have been examined. The skin temperature of both their thenar areas was measured before sympathicotomy, and 5 and 10 minutes after sympathicotomy under general anesthesia, using N2O, O2, enflurane, vecuronium. RESULTS: Under general anesthesia, there was a significant increase of post-sympathicotomy skin temperature on the ipsilateral palm, in contrast to a decrease on contralateral ones. The absolute value was minimal but statistically significant. CONCLUSIONS: Thoracic sympathicotomy may producc simultaneous but different types of sympathetic response on both sides of the hands, though this response is lessened with a use of general anesthesia because inhalation anesthetics induced central and peripheral sympathetic inhibition. We conclude that continuous and careful monitoring of palmar skin temperature yields useful information about intraoperative success during thoracic sympathicotomy under general anesthesia and that we should conduct further study of the contralateral sympathetic response.

Is Palmar Skin Temperature a Indicator for the Success of Thoracic Sympathectomy in Hyperhidrosis Patients? / 대한마취과학회지

BACKGREOUND: The sympathetic investigations during thoracic sympathectomy are essential to an adequate sympathectomy that will lead to sufficient and lasting relief of palmar hyperhidrosis. The measurement of palmar skin temperature has been used as an indicator of success of transcutaneous chemical thoracic sympathectomy. We measured intraoperative palmar skin temperature to know whether it can be used as a same purpose in the endoscopic thoracic sympathectomy under general anesthsia. METHODS: Fifteen patients (18 to 25 years old) with palmar hyperhidrosis underwent endoscopic thoracic sympathectomy under general anesthesia. The palmar skin temperature was measured with a skin probe of a thermometer applied on the both index finger tips. The palmar skin temperature was monitored continuously from the beginning of anesthesia to the complete arousal. RESULTS: The palmar skin temperature increased significantly by about 3 degrees C just after induction. There was no significant difference in the palmar skin temperature between just before sympathectomy and soon after sympathectomy during the endoscopic thoracic sympathectomy. CONCLUSIONS: Intraoperative measurement of palmar skin temperature can not indicate a definite sympathectic denervation during the endoscopic thoracic sympathectomy under general anesthesia.