| Intrathecal Block with 10 % Phenol-Glycerine for Cancer Pain. |
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Hung Kun Oh, Youn Woo Lee, Duck Mi Yoon, Sang Ki Paik, Sou Ouk Bang, Shin Ock Koh |
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Department of Anesthesiology, Yonsei University, College of Medicine, Seoul, Korea. |
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| Abstract |
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Since 1979 forty-three cancer patients have been given intrathecal block at the pain clinic of Yonsei Medical Center. The male patients numbered 23 and female 20 and most of them were in the 4th and 5th decades of age. In 78.6% of the patients, the diagnosis was rectal cancer in 20 cases, cervix cancer in 7 cases, bladder cancer in 4 cases and colon cancer in 3 cases. Thirty six patients with cancer pain were treated by intrathecal 10% phenol-glycerine block and rest of them had only test block. Fourteen patients whose pain sites were lumber or lumber and upper sacral dermatomes were put into the lateral recumbent position on the fluoroscopic table. The spinal puncture was performed as close to the spinal roots to be impregnated as possible. In 22 patients the pain sites were covered by the sacral dermatomes and so the L5-S1 interspace was punctured in the sitting position shifted 15 degree to the affected site.
Fifty one blocks were performed and their results are classified into three categories: good, fair and poor. We achieved good results in 38 patients(77.1%), fair in 6 patients(17.1%) and poor in 2 patient(5.7%). Thus a satisfactory pain relief was achieved in 94.2% of patients.
After intrathecal block with phenol glycerine, transient voiding difficulty was noted in 7, defecation difficulty in 1, and transient paresthesia and/or muscle weakness was present in 3 patients. The mean duration of pain relief was 2.5 months and longer than the mean survival time of 2.25 months. When patients are selected carefully and the block is performed with great caution and good technique, the risk is minimal and a long lasting relief of intractable cancer pain achieves a patinless life until death. |
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