Intraoperative monitoring of evoked potentials of thoracic sympathetic trunk

近年来，内窥镜下胸交感神经切断术治疗手汗症的疗效受到越来越多的关注。我们采用胸交感神经干诱发电位来确定起搏面积，并评价交感神经阻断的强度作为术中监测。16例中13例观察到诱发电位。在研究的16例患者中，2例为慢性多汗症，14例为多汗症。他们的年龄从14岁到65岁不等。)电刺激诱发电位(强度1~5 mA，间隔13毫秒，时程0.1ms，训练170次)。被试着记录在手掌、腋窝、胸部和鞋底。刺激第2、3肋部交感神经干，只在手掌上记录到多相波。这些都没有记录在腋窝、胸部和鞋底。交感神经切除后，刺激第2肋部交感神经干诱发电位消失，第3肋部诱发电位消失。所有病例切除交感神经后，刺激Th2~Th3交感神经干的诱发电位消失。这项研究为内窥镜胸交感神经切断术的正确操作提供了更多信息。

In recent years, the efficacy of endoscopic thoracic sympathectomy for palmar hyperhidrosis has been more closely evaluated. We have adopted the evoked potential of thoracic sympathetic trunk to determine the area of amptation and to evaluate the intensity of sympathetic blockade as an intraoperative monitoring. The evoked potential was observed in 13 cases of 16 cases. (Of the 16 patients studied, 2 were CRPS and 14 were hyperhidrosis. Their ages varied from 14 to 65 years.) The potentials evoked by the electrical stimulation (Intensity:1-5mA, Interval:13msec, Duration:0.1ms, Train:170 times.) were tried to be recorded on palm, axilla, chest, and sole. Multi-phasic waves were recorded only on palm by stimulating the sympathetic trunk on 2nd and 3rd rib. These were not recorded on axilla, chest, and sole. After sympathectomy, though the evoked potentials by stimulating the sympathetic trunk on 2nd rib were observed, those on 3rd rib were disappeared. The evoked potential by stimulating the sympathetic trunk between Th2 and Th3 was disappeared after sympathectomy in all cases. The study provides additional information as to the proper procedure of the endoscopic thoracic sympathectomy.