Total intravenous anesthesia and high-frequency jet ventilation during transthoracic endoscopic sympathectomy for treatment of essential hyperhidrosis palmaris: a new approach.
OBJECTIVE
To evaluate the effects of high-frequency jet ventilation (HFJV) applied to both lungs on hemodynamic parameters, oxygenation, and operating conditions during bilateral videothoracoscopic sympathectomy.


METHODS
A prospective, unblinded study.


METHODS
An ambulatory surgical unit at a university medical center.


METHODS
30 patients (11 men, 19 women), ASA status 1.


METHODS
Bilateral videothoracoscopic sympathectomies were performed using total intravenous anesthesia with propofol, alfentanil, and atracurium, and the patients were ventilated with an oxygen-air mixture using HFJV delivered to both lungs with a Hi-Lo Jet tracheal tube (Mallinckrodt).


RESULTS
Mean total anesthesia time was 55 +/- 13 minutes. Hemodynamic parameters remained stable during surgery, although ablation of the sympathetic ganglia induced three incidences of bradycardia (10% of the patients), which were responsive to atropine. Four patients developed oxygen desaturation (Sa O2 < 90%) after the creation of the pneumothorax. Surgical conditions were considered excellent by the surgeons. Concerning postoperative complications, a temporary Horner's syndrome was observed in one patient. Another patient had a mild residual pneumothorax on the first postoperative day that resolved without insertion of a chest tube.


CONCLUSIONS
It was concluded that HFJV applied to both lungs is an easy and safe anesthetic technique that provides excellent surgical conditions and causes a minor incidence of morbidity.
Department of Anesthesiology, University Hospital. Vrÿe Universiteit Brussel, Belgium.
J
J
D'Haese
F
F
Camu
M
M
Noppen
P
P
Herregodts
M A
MA
Claeys
D000293:Adolescent; D000328:Adult; D000771:Anesthesia, Intravenous; D005260:Female; D006611:High-Frequency Jet Ventilation; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D008297:Male; D011446:Prospective Studies; D013562:Sympathectomy