title: Prediction of compensatory hyperhidrosis with botulinum toxin A and local anesthetic.
abstract: OBJECTIVE
  Compensatory hyperhidrosis (CH) is one of the most problematic complications of sympathectomy, which occurs often and is hard to treat. A predictive procedure (PP) for CH can help patients experience compensatory sweating before sympathectomy to determine whether or not to perform sympathectomy. Our study aimed to evaluate the CH after the PP and sympathectomy in patients with primary palmar hyperhidrosis using multiple drugs.
  
  
  METHODS
  We reviewed 83 patients who underwent a PP between July 2009 and August 2013 with primary palmar hyperhidrosis. In group A, we used levobupivacaine (n = 39). In group B, we used botulinum toxin A plus ropivacaine for the PP in group B (n = 44).
  
  
  RESULTS
  The CH rate after the PP was 44 % (group A) and 25 % (group B), and after sympathectomy 80 % (group A) and 75 % (group B). The prediction value between the PP and the sympathectomy was statistically significant in group A (p < 0.05). The positive prediction rate was 73 % and the negative prediction rate was 27 % in group A.
  
  
  CONCLUSIONS
  Local anesthetic alone has a better predictive value. From our finding, patients should be made aware that CH after sympathectomy is less severe in 73 % of cases than that experienced in the PP.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea.
authors.forename: Jin Yong
authors.initials: JY
authors.lastname: Jeong
authors.affiliation: Department of Anesthesiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea.
authors.forename: Soo Seog
authors.initials: SS
authors.lastname: Park
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea.
authors.forename: Sung Bo
authors.initials: SB
authors.lastname: Sim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea.
authors.forename: Keon Hyon
authors.initials: KH
authors.lastname: Jo
authors.affiliation: Department of Thoracic and Cardiovascular surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea. phenix@catholic.ac.kr.
authors.forename: Jongho
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea.
authors.forename: Saecheol
authors.initials: S
authors.lastname: Oh
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea.
authors.forename: Jae Seong
authors.initials: JS
authors.lastname: Shin
mesh_terms: D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000009:adverse effects; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D002648:Child; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000139:chemically induced* / Q000175:diagnosis* / Q000209:etiology; D000077554:Levobupivacaine; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013562:Sympathectomy / Q000009:adverse effects; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D000077554:Levobupivacaine; D019274:Botulinum Toxins, Type A; D002045:Bupivacaine
keywords: Compensatory hyperhidrosis; Hyperhidrosis; Sympathectomy