Chemical lumbar sympathetic block in the treatment of plantar hyperhidrosis: a study of 69 patients.
BACKGROUND
Plantar hyperhidrosis is a distressing problem that can affect a patient's quality of life. Although various conservative modalities have been suggested, severe plantar hyperhidrosis is often not sufficiently treated.


OBJECTIVE
The aim of this study was to evaluate the safety and the effectiveness of a chemical lumbar sympathetic block (CLSB) with alcohol in patients with severe plantar hyperhidrosis.


METHODS
Sixty-nine patients were treated by a neurolytic lumbar block. A single-needle or two-needle technique was used with patients in the prone position.


RESULTS
Of 138 procedures, the number of successful blocks was 68 (49.3%) for L3 to L4 and 28 (20.3%) for L4 to L5. The degree of anhydrosis was excellent in 6 patients (8.7%), good in 32 patients (46.4%), fair in 32 patients (34.8%), and poor in 7 patients (10.1%). Of 69 patients, 56 (81.1%) were partially or fully satisfied. Noted complications included temporary sexual dysfunction in 1 patient, compensatory hyperhidrosis in 1 patient, and transient genitofemoral neuritis in 3 patients. Although 62 patients (89.9%) recurred at 6 to 18 months, 3 patients (4.3%) remained stable until 18 to 24 months.


CONCLUSIONS
The careful use of CLSB on an outpatient basis can be a safe, minimally invasive, and effective treatment for severe plantar hyperhidrosis.
Kim
Won Oak
WO
Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. drwokim@hanmail.net
Yoon
Kyung Bong
KB
Kil
Hae Keum
HK
Yoon
Duck Me
DM
D000328:Adult; D000431:Ethanol / Q000008:administration & dosage; D005260:Female; D005528:Foot; D006801:Humans; D006945:Hyperhidrosis / Q000628:therapy*; D008161:Lumbosacral Region; D008297:Male; D012189:Retrospective Studies; D013563:Sympathectomy, Chemical; D013565:Sympatholytics / Q000008:administration & dosage; D016896:Treatment Outcome; D055815:Young Adult
D013565:Sympatholytics; D000431:Ethanol