Phenol saddle blocks for intractable pain at end of life: report of four cases and literature review.
Four cancer patients with prior bladder diversions had phenol neurolytic saddle blocks performed for intractable pelvi-sacral pain. All patients had advanced disease, the focus of their treatment being palliative. Treatment limiting side effects precluded further upward titration of systemic analgesic therapies. Pain control improved after intrathecal neurolysis and allowed a greater than 60 percent reduction in systemic opiate dosage. No significant block-related adverse effects were encountered. The value and technical aspects of intrathecal saddle blocks in end-of-life pain management is discussed.
Slatkin
Neal E
NE
Department of Supportive Care and Palliative Medicine, City of Hope National Medical Center, Duarte, California, USA.
Rhiner
Michelle
M
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods*; D010148:Intractable Pain / Q000188:drug therapy* / Q000209:etiology; D010166:Palliative Care; D010386:Pelvic Neoplasms / Q000150:complications*; D017699:Pelvic Pain / Q000188:drug therapy* / Q000209:etiology; D019800:Phenol / Q000627:therapeutic use; D012597:Sclerosing Solutions / Q000627:therapeutic use
D012597:Sclerosing Solutions; D019800:Phenol