Cervical Sympathectomy

Medically reviewed by Drugs.com. Last updated on May 4, 2025.

• Care notes
• Ambulatory
• Discharge
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AMBULATORY CARE:

A cervical sympathectomy

is surgery to destroy or remove nerves in your neck. The surgery is mainly used to treat hyperhidrosis (heavy sweating) in the armpits or on the hands.

How to prepare for surgery:

• Your surgeon will tell you how to prepare. He or she may tell you not to eat or drink anything after midnight before surgery. Arrange to have someone drive you home when you are discharged.
• Tell your surgeon about all your current medicines. He or she will tell you if you need to stop any medicine for surgery, and when to stop. He or she will tell you which medicines to take or not take on the day of surgery.
• Tell your surgeon about any allergies you have, including to anesthesia.
• You may need to have blood tests before your surgery. A cervical spine x-ray, CT scan, or MRI may be done to look at your neck and spinal cord before your surgery. Contrast liquid may be used to help these show up better in pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. You also may need tests to check the function of the nerves in your arms.

What will happen during surgery:

• You will be given general anesthesia to keep you asleep and free from pain during surgery. Your surgeon will make 2 or 3 incisions in your chest, just below your armpit. He or she will collapse your lung. This helps your surgeon see the area better so he or she can find the correct nerves.
• Your surgeon may use chemicals to destroy the nerves. The nerves may instead be cut or removed.
• Your lung will be inflated. The incision will be closed and covered with a bandage to prevent an infection.

What to expect after surgery:

• You may be given medicine to prevent or treat pain or a bacterial infection.
• You will be helped to walk around to prevent blood clots.
• You may have more sweating than usual on your abdomen, back, or legs. This is called compensatory sweating, and it is normal because of the loss of sweating under your arms or on your hands.

Risks of a cervical sympathectomy:

You may bleed more than expected or develop an infection. Your hands may be very dry. You may have eyelid drooping on the surgery side. This is usually temporary. Your nerves, spinal cord, blood vessels, or other tissues may be damaged during surgery. Your lung may not inflate after surgery. A chest drain (tube) may be needed if this happens. You may develop a pleural adhesion (bands of fiber in an area of your lung). This may cause pain when you breathe or cough. Compensatory sweating is sometimes severe. You may need more surgery for severe sweating. The surgery is more successful for hand sweating. You may need more surgery if you had surgery for armpit sweating.

Drugs used to treat this and similar conditions

Call your local emergency number (911 in the US) if:

• You have trouble breathing.
• You suddenly feel lightheaded.
• You cough up blood.
• You have chest pain or pain when you take a deep breath or cough.
• You have new or worsening trouble moving your neck, arms, or legs.

Seek care immediately if:

• Your arm or leg feels warm, tender, and painful. It may look swollen and red.
• Parts of your body are numb, tingly, cool to the touch, or look blue or pale.
• You have pain that gets worse or does not get better with pain medicine.
• You have more bleeding or fluid draining from the surgery area than you were told to expect.
• You have nausea or are vomiting.
• You see signs of infection in the surgery area, such as red streaks or pus.
• You have a headache or muscle aches longer than you were told to expect.

Call your doctor or neurologist if:

• You have a fever.
• You have heavy sweating that continues longer than a couple of days.
• You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

• Antibiotics help prevent or treat a bacterial infection.
• Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Read the labels of all other medicines you are using to see if they also contain acetaminophen, or ask your doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly.
• Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
• Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell your provider if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Self-care:

• Apply ice to the surgery area. Ice can help relieve pain or swelling. Use an ice pack, or put crushed ice in a plastic bag. Wrap a towel around the bag before you apply it to your skin. Apply ice for 15 to 20 minutes every hour, or as directed.
• Ask when you can return to your regular activities. Your healthcare provider will tell you when you can drive, return to work, and do your regular activities. Do not lift anything heavier than your provider says is okay.
• Care for your surgery area as directed. Keep the area covered until your provider says you can remove the bandages. Take showers instead of baths while the surgery area heals. Keep the area dry by covering it before you shower. Do not swim or soak in a hot tub until your provider says it is okay. Change your bandages every day, or as directed. Check for signs of infection, such as red streaks, pus, swelling, or warmth.
• Use lotion if your hands become dry. Dry skin is usually temporary. Use lotion or a hand moisturizer as needed.

Follow up with your doctor or neurologist as directed:

Write down your questions so you remember to ask them during your visits.

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