| Popis: |
Background: Hyperhidrosis is frenquently present in young people, caused much trouble in daily life, especially in communication. Thoracoscopic sympathectomy is an effective and safe method to treat palmar hyperhidrosis. Previously, the double - lumen tube was used. This method was too complex, expensive, accompanied pulmonary injury. We applied anesthesia with single - lumen endotracheal intubation and intrathoracic CO2 insufflation in supine position for thoracoscopic sympathectomy. The objective of this study was to evaluate the result of anesthesia and change of heart rate, arterial blood pressure, the respiration and complication. Methods: A prospective study was realized on 43 patients diagnosed palmar hyperhidrosis, and performed thoracic sympathectomy for the treatment of palmar hyperhidrosis. Patients in supine position were carried out anesthesia with the single - lumen endotracheal intubation and intrathoracic CO2 insufflation at a rate 0.5 - 1 L.min-1, sustained intrathoracic pressure at 5 - 6mmHg insufflation. All the patients were evaluated: heart rate, arterial blood pressure, saturation of peripheral oxygen (SpO2), end-tidal carbon dioxide (EtCO2), peak airway pressure, surgery time for each lung, the complication of surgery and anesthesia, hospital stay. Results: General anesthesia with single - lumen endotracheal intubation, and intrathoracic CO2 insufflation for treating palmar hyperhidrosis was performed successfully in all patients supine position semi Fowler with the mean age 21.28 ± 5.65 (min 11 age - max 42 age), heart rate, arterial blood pressure and respiratory stability during surgery and anesthesia. SpO2 was over 98%, mean hospital stay was 2.84 ± 0.43 days (range 2- 4days). Conclusions: Anesthesia with single - lumen endotracheal intubation and intrathoracic CO2 insufflation in supine position for thoracoscopic sympathectomy was the method that provided good surgery condition, guaranteed intraoperatively heart rate, arterial blood pressure and respiratory stability. This was an effective, safe method. Key words: Single-lumen endotracheal intubation, double-lumen endotracheal tube, thoracoscopic sympathectomy |
