[Neurolytic blocks for cancer pain--still a useful therapeutic strategy].
BACKGROUND
Patients with advanced cancer may present complex sets of symptoms, of which pain is the most prevalent. In addition to systemic pharmacological therapy for pain management, neurolytic blocks are also effective in controlling cancer pain in selected patients.


METHODS
Various neurolytic blocks used in the treatment of cancer pain are reviewed.


RESULTS
Several studies have documented the efficacy of neurolytic blocks in reducing pain intensity and opioid consumption, although good prospective, randomized controlled trials are scarce. The narrow risk-benefit ratio associated with neurolysis techniques requires knowledge of the complications associated with the different neurolytic blocks in order to minimise undesirable effects.


CONCLUSIONS
Interventional techniques continue to play an important role in the management of cancer pain. The quality of the neurolytic blocks improves when they are performed image-guided in collaboration with an interventional radiologist. These blocks should never be considered an isolated treatment, but as a component of a comprehensive therapeutic strategy.
Kongsgaard
Ulf E
UE
Anestesiavdelingen, Det Norske Radiumhospital, Oslo. u.e.kongsgaard@klinmed.uio.no
Bjørgo
Steinar
S
Hauser
Markus
M
D002492:Central Nervous System Depressants / Q000008:administration & dosage*; D000431:Ethanol / Q000008:administration & dosage; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*; D009407:Nerve Block / Q000379:methods; D010148:Intractable Pain / Q000188:drug therapy*; D019800:Phenol / Q000008:administration & dosage
D002492:Central Nervous System Depressants; D019800:Phenol; D000431:Ethanol