In which type of patients should cervical sympathectomy be avoided?

Cervical sympathectomy is a surgical procedure that disrupts sympathetic nerve pathways, primarily used to manage conditions like hyperhidrosis or complex regional pain syndrome. Its effects on the autonomic nervous system can lead to significant physiological changes that may not be suitable for certain patient populations.

In patients with scleroderma, the autonomic dysregulation associated with the disease might be exacerbated by cervical sympathectomy. Scleroderma is characterized by vascular changes and alterations in skin and organ perfusion. The sympathetic nervous system plays a crucial role in regulating blood flow and sweat production. Disrupting these pathways can worsen symptoms and lead to further complications, including exacerbation of skin fibrosis and impaired circulation, which are already compromised in these patients.

The other categories of patients, such as those with asthma, rheumatoid arthritis, or diabetes, may exhibit symptoms or conditions that could be managed by cervical sympathectomy, though caution is still warranted. However, the direct implications of autonomic dysfunction and vascular challenges in scleroderma patients make the avoidance of this procedure particularly important for their overall health and well-being.