Glanddier G, Levadoux H, Jacquemet L R
Acta Chir Belg. 1977 Jan;76(1):81-7.
Authors report 163 cases of lumbar sympathectomy they did under local anesthesia from 1968 to 1975. All were older--and poor risk patients. Approach was always lumbar with resection of distal part of the 12th rib. If good care is taken to do anesthesia infiltration of the five lower intercostal nerves and of the 1st and 2nd posterior lumbar nerves, anesthesia is quite good, and surgery easy and painless. The main advantages are:--easy excision of the first lumbar sympathetic node through this lumbar approach;--low lethality as far as authors consider almost no contra-indications;--very fast recovery of bowel movements;--immediate oral feeding which is important for diabetic patients;--no tracheal, bronchial or lung postoperative infestation or trouble. Patients have never had any trouble (convulsions) from lignocaine since gardenal is given in pre-anesthesia.
作者报告了他们在1968年至1975年期间在局部麻醉下进行的163例腰交感神经切除术病例。所有患者均为老年且风险较高的患者。手术入路均为经腰部，切除第12肋远端。如果小心地对下五条肋间神经和第一、二腰后神经进行麻醉浸润，麻醉效果相当好，手术轻松且无痛。主要优点有：——通过这种腰部入路易于切除第一腰交感神经节；——就作者认为几乎没有禁忌证而言，致死率低；——肠蠕动恢复非常快；——可立即经口进食，这对糖尿病患者很重要；——术后无气管、支气管或肺部感染或问题。自从在麻醉前给予苯巴比妥后，患者从未因利多卡因出现过任何问题（惊厥）。
