Abstract
Intractable cancer pain continues to be a difficult problem for pain management specialists. Even with current oral analgesics, many patients have side effects from opioids and chemotherapy that limit their quality of life. Interventional treatments, such as peripheral and intrathecal neurolysis with alcohol and phenol, can be effective but have potential motor paralysis. Other potent intrathecal analgesics: ziconotide, opioids, bupivacaine, and clonidine, need to be administered by an external or internal, implantable drug delivery system (IDDS), which, with end of life care, can be hard to coordinate. Modern intrathecal alternatives, resiniferatoxin and saporin, offer prolonged analgesia, but their delivery avoids motor dysfunction. The following chapter will explore the neurolytic block techniques currently employed and these novel natural compounds being studied for future techniques for cancer pain relief.
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Sayal, P., Leong, M.S., Copenhaver, D. (2019). Chemodenervation: Neurolytic Blockade and Potent Neurotoxins for the Treatment of Cancer Pain. In: Deer, T., Pope, J., Lamer, T., Provenzano, D. (eds) Deer's Treatment of Pain. Springer, Cham. https://doi.org/10.1007/978-3-030-12281-2_35
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DOI: https://doi.org/10.1007/978-3-030-12281-2_35
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