Intrathecal neurolytic blocks for the relief of cancer pain

Best Pract Res Clin Anaesthesiol. 2003 Sep;17(3):407-28. doi: 10.1016/s1521-6896(03)00016-8.

Abstract

Intrathecal neurolytic blocks for the treatment of chronic pain were first described by Dogliotti in 1931. Since then, many authors have described the intrathecal injection of various neurolytic substances for the treatment of oncologic pain. In recent years, alcohol and phenol have been the substances most commonly used for this purpose. There are no controlled studies, so the literature consists of observations, reports and book chapters reflecting the opinions of experienced clinicians. This chapter describes the indications, contraindications, potential complications, and expected benefits of intrathecal injection of alcohol and phenol in the treatment of cancer pain. Four cases of cancer patients whose intractable pain was treated by the authors using intrathecal neurolysis are presented. Pertinent literature is reviewed. In this account, the emphasis is on proper selection of patients and techniques.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Aged
  • Anesthetics, Local / administration & dosage
  • Anesthetics, Local / therapeutic use
  • Clinical Trials as Topic
  • Ethanol / administration & dosage
  • Ethanol / adverse effects
  • Ethanol / therapeutic use
  • Female
  • Humans
  • Injections, Spinal
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Nerve Block / adverse effects
  • Nerve Block / methods*
  • Pain, Intractable / etiology
  • Pain, Intractable / therapy*
  • Phenol / administration & dosage
  • Phenol / adverse effects
  • Phenol / therapeutic use
  • Subarachnoid Space

Substances

  • Anesthetics, Local
  • Phenol
  • Ethanol