The amount of compensatory sweating depends on the patient, the damage that the white rami communicans incurs, and the amount of cell body reorganization in the spinal cord after surgery.
Other potential complications include inadequate resection of the ganglia, gustatory sweating, pneumothorax, cardiac dysfunction, post-operative pain, and finally Horner’s syndrome secondary to resection of the stellate ganglion.
www.ubcmj.com/pdf/ubcmj_2_1_2010_24-29.pdf

After severing the cervical sympathetic trunk, the cells of the cervical sympathetic ganglion undergo transneuronic degeneration
After severing the sympathetic trunk, the cells of its origin undergo complete disintegration within a year.
http://onlinelibrary.wiley.com/doi/10.1111/j.1439-0442.1967.tb00255.x/abstract

Thursday, January 3, 2013

Complications of endoscopic sympathectomy - hypoxia, hypotension, haemothorax, pneumothorax

"there are some potentially serious anaesthetic sequelae. Despite the use of various analgesic techniques, including intrapleural bupivacaine and systemic opioids, postoperative chest pain is a common and distress- ing feature, with a duration of 12 hours or more.
In a recent prospective study of 58 patients undergoing this procedure, Jedeikin et al reported hypoxia (with an arterial oxygen saturation of 70%) and hypotension (with decrease in arterial pressure to < 50mmHg) as uncommon but important complications.
'These events maybe the result of compression of the mediastinum and major vessels by carbondioxide insufflation. In addition, during bilateral procedures, lesser degrees of hypoxia were common place with deflation of the lung on the second side, despite apparently adequate reinflation of the first lung. 15%  of patients had pneumothorax and 7% required underwater drainage for haemothorax or pneumothorax."

A C QUINN R E EDWARDS PJNEWMAN W J FAWCETT
BMJ VOLUME 306 26JUNE1993