Hartrey R, Poskitt K R, Heather B P, Durkin M A
Department of Anaesthesia, Cheltenham General Hospital, England.
Eur J Surg Suppl. 1994(572):33-6.
Transthoracic endoscopic sympathectomy is now considered the treatment of choice for patients with upper limb hyperhidrosis requiring sympathetic ablation. This procedure requires the use of an endobronchial double lumen tube and subsequent one-lung anaesthesia, a technique that is associated with a number of potential problems. Full patient monitoring is thus required and includes pulse, ECG, non-invasive blood pressure measurement, pulse oximetry, end-tidal carbon dioxide concentration and peak inspiratory airway pressure. We reviewed our anaesthetic technique and peri-operative complications in 26 patients, to assess patient safety. In our study hypoxaemia occurred commonly but was transient in all bar one case where re-expansion of the lung was required. Hypotension occurred at two stages of the procedure, but active intervention was not required, and two patients required underwater drainage of the pleural cavity for treatment of pneumothorax. With skilled anaesthetic personnel and adequate monitoring this procedure may be carried out safely.
经胸内镜交感神经切除术目前被认为是需要进行交感神经切除术的上肢多汗症患者的首选治疗方法。该手术需要使用支气管内双腔导管并随后进行单肺麻醉，这是一种存在许多潜在问题的技术。因此需要对患者进行全面监测，包括脉搏、心电图、无创血压测量、脉搏血氧饱和度、呼气末二氧化碳浓度和吸气峰值气道压力。我们回顾了26例患者的麻醉技术和围手术期并发症，以评估患者的安全性。在我们的研究中，低氧血症很常见，但除了1例需要肺复张的病例外，其余均为短暂性。低血压在手术的两个阶段发生，但无需积极干预，2例患者需要胸腔闭式引流治疗气胸。有经验丰富的麻醉人员和充分的监测，该手术可以安全进行。
