[Alternative one lung ventilation anesthesia for bilateral thoracoscopic sympathectomy].
Palmar hyperhidrosis (PH) is a common disorder in the oriental subtropical area. There have been many therapeutic methods, such as: oral medication, local treatment and traditional surgical operation, but none of them has proved entirely satisfactory. Since the development of video endoscopic surgery, transthoracic endoscopic sympathectomy has been increasing day by day. This study consisted of 124 PH patients under alternative one lung ventilation anesthesia for bilateral thoracoscopic laser sympathectomy. The age of patients ranged from 13 to 64 years, male 45 and female 79. The average anesthesia duration was 60 min. We used glycopyrrolate 0.03 mg/kg, decardon 1 mg/10 kg for premedication. Induction was with fentanyl 0.07 ml/kg, atracurium 0.6 mg/kg and thiopental 4 mg/kg. Maintenance was with isoflurane in 3L/min. oxygen inhalation. The alternative one lung ventilation anesthesia was achieved with double-lumen endobronchial tube. Fr 37, Fr 35, Fr 28 Sheridan Lt. double-lumen bronchial tube were used depending upon the sex and fudgement of the individual patient. All patients tolerated the procedure well so that sympathectomy could be performed smoothly and uneventfully. Immediately after the operation, a transient mild to moderate degree of difficult breathing and substernal discomfort were experienced in the majority of patients. These suffering often relieved spontaneously or with some common analgesic.
Ho
C S
CS
Department of Anesthesiology, Taiwan Adventist Hospital.
Kao
M C
MC
D000293:Adolescent; D000328:Adult; D000758:Anesthesia / Q000379:methods*; D001980:Bronchi; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D007440:Intubation; D008297:Male; D008875:Middle Aged; D013562:Sympathectomy / Q000379:methods*; D013906:Thoracoscopy