Effect of chemical sympathectomy on muscle blood flow.

Lumbar chemical sympathectomy using 5% phenol in glycerin alleviated intermittent claudication and improved cutaneous blood flow. This technic permits instituting physiotherapy and exercises to improve collateral circulation. The procedure was performed 56 times on 29 cases. No significant complication was observed. Muscle blood flow (MBF) was measured by 133Xe clearance, at rest and following exercise. Total blood flow (TBF) of the leg was measured by the impedance method, and increased cutaneous blood flow was confirmed by thermogram and photoplethysmogram. TBF increased significantly following exercise after sympathectomy. The ratio of MBF at rest and after exercise increased significantly in m. gastrocnemius, a white muscle, but was not significant in m. anterior tibialis, a red muscle. Chemical lumbar sympathectomy also produces preganglionic neurolysis to suppress vascular hypersensitivity after surgical ganglionectomy.