Study of sympathetic nerve block on peripheral vascular disease.

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The effects and complications of chemical sympathectomy conducted in the Department of Anesthesiology on 176 cases of peripheral vascular disease during the 12 years were studied retrospectively.No difference could be observed in the effects of thoracic chemical sympathectomy between anterior and posterior approach, but the number of complications was greater in the anterior approach group than posterior approach group. In view of these findings the posterior approach is commonly employed at present.In lumbar chemical sympathectomy, two types of approaches have been employed. In the "near" group, the needle is placed 5-6cm lateral to spinous processes, while in the "far" group it is placed 7-8cm lateral to the processes. No significant difference has been demonstrated between the two on the effects of lumbar chemical sympathectomy. As the complications were more frequent in the "near" group than in the "far" group, the 7-8cm approach is mostly employed at present. The needle position and spread of contrast medium are confirmed by X-ray.With the advances made year by year in chemical sympathectomy, this procedure can be performed with greater safety and ease. Chemical sympathectomy is now regarded to be the treatment of first choice for peripheral vascular disease.
日本臨床麻酔学会の論文