Hemodynamic Changes Using Esophageal Doppler during a Thoracoscopic Thoracic Sympathicotomy in Primary Hyperhidrosis / 대한마취과학회지

ABSTRACT

BACKGROUND: Among the treatments for hyperhidrosis, thoracoscopic sympathicotomy is comparatively easy and simple to operate, so complications rarely occur. Since the thoracic sympathetic nerve controls the cardiovascular system, there should be hemodynamic changes after the operation. However, little study has been done up on describing the overall hemodynamic changes occurring during operation. Therefore, we examined hemodynamic changes by Esophageal Doppler. METHODS: This research was conducted on thirteen patients with hyperhidrosis, from 15 to 50 years who were group 1 or 2, according to the American Society of Anesthesiologists (ASA) classification, and were without heart disease, respiratory disease or esophageal disease. Induction was done using TCI Diprivan 4.5microgram/ml, vecuronium 0.1 mg/kg at maintained with 50% nitrous oxide. Hemodynamic parameters such as heart rate, mean arterial pressure and cardiac output and tissue oximeter were examined after anesthesia was induced, and CO2 given, that is, immediately before thoracic sympathicotomy and after thoracic sympathicotomy. RESULTS: The mean heart rate was 89 +/- 12 beats/min just before thoracic sympathicotomy, after surgery this decreased statistically. Mean tissue oxygen saturation in the arm was 77 +/- 10% just after surgery, and this was a significant increase compared with that before surgery (P<0.05). Cardiac output by esophageal doppler decreased statistically after induction. CONCLUSIONS: During thoracoscopic thoracic sympathicotomy in primary hyperhidrosis, the heart rate decreased, cardiac output using esophageal doppler showed a significant decrease at each time, and there was not any differences between each time.