Monitoring: Equipment and Computers
Background: Endoscopic thoracic sympathectomy (ETS) is a minimally invasive procedure for treating palmar hyperhidrosis (PH). Hemodynamic changes occurs with CO insufflation during ETS (1,2). In the present study hemodynamic changes were examined during ETS under general anesthesia using impedance cardiography (ICG).
Patients and Methods: 17 adult patients(15 males) scheduled to undergo elective unilateral ETS for treatment of PH were randomly enrolled in the study. Patients with cardio-respiratory disease were excluded from the study. Their age, and weight mean values were 26.5 ± 5 yr, 71.9 ± 11.5 kg respectively. Besides routine monitoring, ICG monitor was used to measure cardiac output (CO), cardiac index (CI), stroke volume (SV) and total fluid content (TFC) (3). For statistical analysis, three phases were defined for data collection: A, prior to CO insufflation, B (at 10, 5 and 2mmHg IPP), during and C, after gas deflation. ANOVA was used for statistical analysis.
Conclusions: Significant reduction of CO, CI and SV were detected in the present study, but they were of no clinical significance. Of interest was the significant reduction of TFC during CO insufflation. Whether reduced TFC correlates to magnitude of compression, with subsequent hemodynamic changes, exerted on the closed hemithorax by CO insufflation, yet to be further studied.
1 Fredman B, Olsfanger D, Jedeikin R. Brit J Anaesth 2004; 79: 113-119.
2 El-Dawlatly AA, Al-Dohayan A, Samarkandi A, et al. Annales Chirurgiae et Gynecologiae 2001; 90: 206-208.
3 Pianosi PT. Chest 1997; 111: 333-337.