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Effect of Chemical Sympathectomy on Muscle Blood Flow

TATSUSHI FUJITA, MD, PhD, FACA^*, YASUHARU KITANI, MD, PhD, TAKASHI NAKAMURA, MD, and TOMIKO KIMURA, MD

*Professor and Chairman, Department of Anesthesiology, Gunma University Hospital, Maebashi, Japan. Assistant Professor, Department of Anesthesiology, Gunma University Hospital, Maebashi, Japan. Fellow in Anesthesiology, Department of Anesthesiology, Gunma University Hospital, Maebashi, Japan.

Abstract

Lumbar chemical sympathectomy using 5 percent phenol in glycerin alleviated intermittent claudication and improved cutaneous blood flow. This technic permits instituting physiotherapy and exercises to improve collateral circulation. The procedure was performed 56 times on 29 cases. No significant complication was observed. Muscle blood flow (MBF) was measured by ¹³³Xe clearance, at rest and following exercise. Total blood flow (TBF) of the leg was measured by the impedance method, and increased cutaneous blood flow was confirmed by thermogram and photoplethysmogram.

TBF increased significantly following exercise after sympathectomy. The ratio of MBF at rest and after exercise increased significantly in m. gastrocnemius, a white muscle, but was not significant in m. anterior tibialis, a red muscle.

Chemical lumbar sympathectomy also produces preganglionic neurolysis to suppress vascular hypersensitivity after surgical ganglionectomy.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999