Efectos de la simpatectomía torácica sobre la pletismografía de los miembros superiores en sujetos con hiperhidrosis palmar

Citation data:

instname:Universidad del Rosario

Publication Year:
2015
Usage 293
Abstract Views 293
Repository URL:
http://repository.urosario.edu.co/handle/10336/10185
Author(s):
Pérez Coronado, Juan David; Arias Duran, Carlos Arturo; Arias, Juan Manuel; Echeverri, Dario; Cedano, Francisco Javier; Téllez, Luis Jaime; Garzón, Juan Carlos; Osorio, Camilo; Especialista en Anestesiología FCI
Publisher(s):
Facultad de Medicina; Universidad del Rosario
Tags:
hiperhidrosis palmar; fotopletismografía; simpatectomía torácica; 617.96; Sympathectomy; palmar hyperhidrosis; photoplethysmography; Anestesiología; Simpatectomía torácica; Pletismografía; Hiperhidrosis palmar
thesis / dissertation description
Introduction: Sympathectomy is used for the treatment of palmar hyperhidrosis with sympathetic denervation in upper limbs. It has an effect on blood flow because of it’s impact in vasoconstrictor response. The change in blood flow can be evaluated through the photoplethysmographic waveform. Methodology: 2 sessions (preoperative and postoperative) were performed for 10 minutes in each upper limb in 28 patients obtaining 79 photoplethysmographic signals: 37 presympathectomy and 42 postsympathectomy. Each signal was analyzed for 1.5 minutes. We obtained 80 waves and measured 6 variables: 1. AC component (pulsatile component), 2. Component DC (non-pulsatile component), 3. Ratio AC / DC (perfusion index), 4. Area under the curve (AUC), 5. time between the start of the peak systolic wave (T_DA) and 6. Time between pulse wave (T_DD). Results: AC increased 120% and DC decreased 78% of the right upper extremity (RUE) with a 99% confiability (p <0.001) between presympathectomy (n=18) and postsympathectomy (n=21). AC/DC increased 55% with a 95% confiability between presympathectomy (n=19) and post-sympathectomy (n=21) in the left upper extremity (p <0.05). No difference in T_DA, T_DD or AUC was observed. Discussion and Conclusion: Sympathectomy in patients with palmar hyperhidrosis causes a change in blood flow to the upper limbs as evidenced by the changes in non- pulsatile (DC) and pulsatil component (AC). This change may be secondary to vasodilation due to surgical sympathetic denervation of the thoracic sympathetic ganglia.