Should we all have a sympathectomy at birth? Or at least preoperatively?
The sympathetic nervous system appears useful to wild animals in helping to mobilize energy stores and in facilitating escape from threatening situations. But, as the article by Stone et al. in this issue of ANESTHESIOLOGY suggests, such reactions may not be beneficial in anesthetized humans inasmuch as myocardial oxygen requirement may increase beyond supply. Do the adverse effects of stress now outweigh the benefits an intact sympathetic nervous system conveys? Should we ideally all be sympathectomized at birth, or at least preoperatively? Before answering this not so tongue-in-cheek question, we should first consider the details of this study by Stone et al. which has stimulated this question.