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Transthoracic endoscopic sympathectomy (TES) is an effective treatment for palmar hyperhidrosis. We review our experience and discuss the anesthetic technique and perioperative complications encountered in 110 patients undergoing TES for palmar hyperhidrosis. All patients were monitored with EKG, NIBP and pulse oximetry (SPO2) during the operation. The trachea was intubated with a single lumen endotracheal tube and ventilation was controlled manually. 100% inspired oxygen was necessary during TES to avoid hypoxia. One patient developed sudden cardiac arrest during electrocauterization of the left sympathetic chain and two patients required underwater drainage for hemothorax. Minimal pneumothorax was diagnosed in 4 patients and all cases resolved spontaneously without active treatment.
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