Clinical StudyCT-guided thoracic sympathetic blockade for palmar hyperhidrosis: Immediate results and postoperative quality of life

- CT-guided percutaneous puncture thoracic sympathetic blockade is an effective and minimally invasive technique for the treatment of palmar hyperhidrosis.
- The therapeutic success rate was high and the technique was very safe.
- This procedure can be an alternative to surgical approaches, but further studies with large series are needed.

The purpose of this study was to evaluate the results, complications, and degree of satisfaction among patients who underwent a CT-guided percutaneous puncture thoracic sympathetic blockade. A total of 186 patients underwent CT-guided thoracic sympathetic blockade based on case histories and a prospective pre- and postoperative questionnaire survey. The study sample was composed of 93 patients with an age range from 18 to 34 years and a diagnosis with primary palmar hyperhidrosis (severe in some patients). Percutaneous puncture thoracic sympathetic blockade guided by CT was performed under local anesthesia in all patients. Heart rate (HR), non-invasive blood pressure (NIBP), arterial oxygen saturation (SPO2), perfusion index (PI), and palmar temperature (T) were monitored before and after treatment. Follow-up included a questionnaire on life quality and degree of satisfaction. Ten minutes after treatment, the SPO2, PI, and temperature all raised remarkably ([92.75 ± 2.02]% vs. [98.85 ± 1.09]%, [1.55 ± 0.69]% vs. [8.60 ± 0.94]%, [30.95 ± 1.27]°C vs. [35.75 ± 0.55]°C, respectively, P < 0.001). The therapeutic success rate was 96.7%. No operative mortality was recorded. No complications were observed, except transient bradycardia in one patient and transient injection site pain in 25 patients. Of the 89 patients who were monitored over a period of 6-12 months through follow-up interviews and questionnaires, 46% developed compensatory hyperhidrosis, 87.6% reported improvement in their quality of life. CT-guided percutaneous puncture thoracic sympathetic blockade is a safe, effective, and minimally invasive technique for the treatment of palmar hyperhidrosis. Despite the high rate of compensatory hyperhidrosis, it produces a high rate of patient satisfaction.