Central Neuraxial Neurolysis

Chapter

Abstract

Central neuraxial neurolytic blockade is intended to destroy, selectively, sensory dorsal nerve roots and rootlets between the spinal cord and dorsal root ganglion (DRG) to prevent transmission of nociceptive impulses through the spinal cord. Preservation of motor, bladder, and bowel function is the goal with optimal analgesia.

Keywords

Spinal Cord Dorsal Root Ganglion Nerve Root Bowel Dysfunction Celiac Plexus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Ballantyne JC, Fishman SM, Rathmell JP. Bonica’s management of pain. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2009.Google Scholar
  2. 2.
    Ferrer-Brechner T. Anesthetic techniques for the management of cancer pain. Cancer. 1989;63(11 Suppl):2343–7.PubMedCrossRefGoogle Scholar
  3. 3.
    Candido K, Stevens RA. Intrathecal neurolytic blocks for the relief of cancer pain. Best Pract Res Clin Anaesthesiol. 2003;17(3):407–28.PubMedCrossRefGoogle Scholar
  4. 4.
    Suvansa S. Treatment of tetanus by intrathecal injection of carbolic acid. Lancet. 1931;1:1075, 1075–8.CrossRefGoogle Scholar
  5. 5.
    Miller RD, Johnston RR, Hosobuchi Y. Treatment of intercostal neuralgia with 10 per cent ammonium sulfate. J Thorac Cardiovasc Surg. 1975;69(3):476–8.PubMedGoogle Scholar
  6. 6.
    Grouls RJ, Meert TF, Korsten HH, Hellebrekers LJ, Breimer DD. Epidural and intrathecal n-butyl-p-aminobenzoate solution in the rat. Comparison with bupivacaine. Anesthesiology. 1997;86(1):181–7.PubMedCrossRefGoogle Scholar
  7. 7.
    Ischia S, Luzzani A, Ischia A, Magon F, Toscano D. Subarachnoid neurolytic block (L5–S1) and unilateral percutaneous cervical cordotomy in the treatment of pain secondary to pelvic malignant disease. Pain. 1984;20(2):139–49.PubMedCrossRefGoogle Scholar
  8. 8.
    Lipton S. Persistent pain: modern methods of treatment. New York: Grune & Stratton; 1977.Google Scholar
  9. 9.
    Iggo A, Walsh EG. Selective block of small fibres in the spinal roots by phenol. Brain. 1960;83:701–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Slatkin NE, Rhiner M. Phenol saddle blocks for intractable pain at end of life: report of four cases and literature review. Am J Hosp Palliat Care. 2003;20(1):62–6.PubMedCrossRefGoogle Scholar
  11. 11.
    Maher RM. Relief of pain in incurable cancer. Lancet. 1955;268(6853):18–20.PubMedCrossRefGoogle Scholar
  12. 12.
    Hansebout RR, Cosgrove JB. Effects of intrathecal phenol in man. A histological study. Neurology. 1966;16(3):277–82.PubMedCrossRefGoogle Scholar
  13. 13.
    Smith MC. Histological findings following intrathecal injections of phenol solutions for relief of pain. Br J Anaesth. 1964;36:387–406.PubMedCrossRefGoogle Scholar
  14. 14.
    Wood KM. The use of phenol as a neurolytic agent: a review. Pain. 1978;5(3):205–29.PubMedCrossRefGoogle Scholar
  15. 15.
    Lifshitz S, Debacker LJ, Buchsbaum HJ. Subarachnoid phenol block for pain relief in gynecologic malignancy. Obstet Gynecol. 1976;48(3):316–20.PubMedGoogle Scholar
  16. 16.
    Totoki T, Kato T, Nomoto Y, Kurakazu M, Kanaseki T. Anterior spinal artery syndrome – a complication of cervical intrathecal phenol injection. Pain. 1979;6(1):99–104.PubMedCrossRefGoogle Scholar
  17. 17.
    Raj PP. Clinical practice of regional anesthesia. New York: Churchill Livingstone; 2002.Google Scholar
  18. 18.
    Woolsey RM, Taylor JJ, Nagel JH. Acute effects of topical ethyl alcohol on the sciatic nerve of the mouse. Arch Phys Med Rehabil. 1972;53(9):410–4.PubMedGoogle Scholar
  19. 19.
    Rumsby MG, Finean JB. The action of organic solvents on the myelin sheath of peripheral nerve tissue. II. Short-chain aliphatic alcohols. J Neurochem. 1966;13(12):1509–11.PubMedCrossRefGoogle Scholar
  20. 20.
    Gallager HS, Yonezawa T, Hay RC, Derrick WS. Subarachnoid alcohol block. II. Histologic changes in the central nervous system. Am J Pathol. 1961;38:679–93.PubMedCentralPubMedGoogle Scholar
  21. 21.
    Matsuki M, Kato Y, Ichiyanagi K. Progressive changes in the concentration of ethyl alcohol in the human and canine subarachnoid spaces. Anesthesiology. 1972;36(6):617–21.PubMedCrossRefGoogle Scholar
  22. 22.
    El-Sayed GG. A new catheter technique for thoracic subarachnoid neurolysis in advanced lung cancer patients. Pain Pract. 2007;7(1):27–30.PubMedCrossRefGoogle Scholar
  23. 23.
    Korevaar WC. Transcatheter thoracic epidural neurolysis using ethyl alcohol. Anesthesiology. 1988;69(6):989–93.PubMedCrossRefGoogle Scholar
  24. 24.
    Mehta M, Salmon N. Extradural block. Confirmation of the injection site by X-ray monitoring. Anaesthesia. 1985;40(10):1009–12.PubMedCrossRefGoogle Scholar
  25. 25.
    Shulman M, Harris JE, Lubenow TR, Nath HA, Ivankovich AD. Comparison of epidural butamben to celiac plexus neurolytic block for the treatment of the pain of pancreatic cancer. Clin J Pain. 2000;16(4):304–9.PubMedCrossRefGoogle Scholar
  26. 26.
    Gerbershagen HU. Neurolysis. Subarachnoid neurolytic blockade. Acta Anaesthesiol Belg. 1981;32(1):45–57.PubMedGoogle Scholar
  27. 27.
    Hay RC. Subarachnoid alcohol block in the control of intractable pain: report of results in 252 patients. Anesth Analg. 1962;41:12–6.PubMedGoogle Scholar
  28. 28.
    Patt RB, Wu CL, Reddy S, Perkins FM, Isaacson S. The incidence of postdural puncture headache following intrathecal neurolysis with large caliber needles. Reg Anesth. 1994;19(2S):86.Google Scholar
  29. 29.
    Charlton JE, Macrae WA. In: Cousins MJ, Bridenbaugh PO, editors. Neural blockade in clinical anesthesia and management of pain. Complications of Neurolytic Neural Blockade. 2nd ed. Philadelphia: Lippincott; 1998.Google Scholar
  30. 30.
    Coles PG, Thompson GE. The role of neurolytic blocks in the treatment of cancer pain. Int Anesthesiol Clin. 1991;29(1):93–104.PubMedCrossRefGoogle Scholar
  31. 31.
    Swerdlow M. Intrathecal neurolysis. Anaesthesia. 1978;33(8):733–40.PubMedCrossRefGoogle Scholar
  32. 32.
    Hughes JT. Thrombosis of the posterior spinal arteries. A complication of an intrathecal injection of phenol. Neurology. 1970;20(7):659–64.PubMedCrossRefGoogle Scholar
  33. 33.
    McGarvey ML, Ferrante FM, Patel RS, Maljian JA, Stecker M. Irreversible spinal cord injury as a complication of subarachnoid ethanol neurolysis. Neurology. 2000;54(7):1522–4.PubMedCrossRefGoogle Scholar
  34. 34.
    Wong GY, Brown DL. Transient paraplegia following alcohol celiac plexus block. Reg Anesth. 1995;20(4):352–5.PubMedGoogle Scholar
  35. 35.
    Hayakawa J, Kobayashi O, Murayama H. Paraplegia after intraoperative celiac plexus block. Anesth Analg. 1997;84(2):447–8.PubMedGoogle Scholar
  36. 36.
    Brown DL, Rorie DK. Altered reactivity of isolated segmental lumbar arteries of dogs following exposure to ethanol and phenol. Pain. 1994;56(2):139–43.PubMedCrossRefGoogle Scholar

Copyright information

© American Academy of Pain Medicine 2015

Authors and Affiliations

  1. 1.Department of Pain ManagementAnesthesia Institute, CCFClevelandUSA
  2. 2.ParmaUSA

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