An application of regional nerve blocks in the treatment of pain in palliative care patients
Abstract
The effective pain treatment sometimes requires to apply the combination of various techniques. Interventional methods, particularly relatively easy to perform regional blocks, may be helpful in treatment of intractable pain as well as applied in patients who prefer reduction of drug consumption. The reasons for such choice tend to be unpleasant adverse effects of medications or polypharmacy due to treatment of co-existing diseases. Interventional methods are used concurrently with rehabilitation, physiotherapy, lymphatic massage, transdermal, electric nerve stimulation and pharmacology treatment. Regional nerve blocks may be used not only as part of therapy but also as a type of anesthesia without the need of inducing sedation by intravenous route, for example during painful dressing changes or debriefing pressure sores. In this article possibilities of an application of several basic regional blocks were submitted with a few clinical examples of palliative care patients
Keywords: nerve blocksregional anesthesiapain in cancer patients
References
- Bochenek A, Reicher M. Anatomia Człowieka. Tom IV i V. PZWL, Warszawa 1989.
- Hadzić A. Blokady nerwów obwodowych Wyd 2. Medmedia, Warszawa 2013.
- Gray AT. Atlas technik znieczulenia regionalnego pod kontrolą ultrasonograficzną. , Wrocław 2012.
- Fernandes M, Barbosa M, Sousa A, et al. Suprascapular Nerve Block: Important Procedure in Clinical Practice. Brazilian Journal of Anesthesiology. 2012; 62(1): 96–104.
- Gorthi V, Moon YL, Kang JH. The effectiveness of ultrasonography-guided suprascapular nerve block for perishoulder pain. Orthopedics. 2010; 33(4).
- Mercadante S, Sapio M, Villari P. Suprascapular nerve block by catheter for breakthrough shoulder cancer pain. Reg Anesth. 1995; 20(4): 343–346.
- Ebraheim NA, Whitehead JL, Alla SR, et al. The suprascapular nerve and its articular branch to the acromioclavicular joint: an anatomic study. J Shoulder Elbow Surg. 2011; 20(2): e13–e17.
- Price DJ. What local anesthetic volume should be used for suprascapular nerve block? Reg Anesth Pain Med. 2008; 33(6): 571; author reply 571–571; author reply 573.
- elinek P, et al. Ganglion stellatum blockade is a suitable tool to control the post–mastectomy pain syndrome. Austral-Asian J Cancer. 2006; 5: 185–189.
- Forouzanfar T, van Kleef M, Weber WE. Radiofrequency lesions of the stellate ganglion in chronic pain syndromes: retrospective analysis of clinical efficacy in 86 patients. Clin J Pain. 2000; 16(2): 164–168.
- Jadon A. Revalidation of a modified and safe approach of stellate ganglion block. Indian J Anaesth. 2011; 55(1): 52–56.
- Imani F, Hemati K, Rahimzadeh P, et al. Effectiveness of Stellate Ganglion Block Under Fuoroscopy or Ultrasound Guidance in Upper Extremity CRPS. J Clin Diagn Res. 2016; 10(1): UC09–UC12.
- Matchett G. Intercostal Nerve Block and Neurolysis for Intractable Cancer Pain. J Pain Palliat Care Pharmacother. 2016; 30(2): 114–117.
- Kirschner JS, Foye PM, Cole JL. Piriformis syndrome, diagnosis and treatment. Muscle Nerve. 2009; 40(1): 10–18.
- Mullin V, de Rosayro M. Caudal steroid injection for treatment of piriformis syndrome. Anesth Analg. 1990; 71(6): 705–707.
- Fishman L, Dombi G, Michaelsen C, et al. Piriformis syndrome: Diagnosis, treatment, and outcome—a 10-year study. Archives of Physical Medicine and Rehabilitation. 2002; 83(3): 295–301.
- Hernando MF, Cerezal L, Pérez-Carro L, et al. Deep gluteal syndrome: anatomy, imaging, and management of sciatic nerve entrapments in the subgluteal space. Skeletal Radiol. 2015; 44(7): 919–934.
- Smith HS, Busracamwongs A. Management of hiccups in the palliative care population. Am J Hosp Palliat Care. 2003; 20(2): 149–154.
- Calvo E, Fernández-La Torre F, Brugarolas A. Cervical phrenic nerve block for intractable hiccups in cancer patients. J Natl Cancer Inst. 2002; 94(15): 1175–1176.
- Renes SH, van Geffen GJ, Rettig HC, et al. Ultrasound-guided continuous phrenic nerve block for persistent hiccups. Reg Anesth Pain Med. 2010; 35(5): 455–457.
- Kuusniemi K, Pyylampi V. Phrenic nerve block with ultrasound-guidance for treatment of hiccups: a case report. J Med Case Rep. 2011; 5: 493.
- Sollerman C, Ejeskär A. Sollerman hand function test. A standardised method and its use in tetraplegic patients. Scand J Plast Reconstr Surg Hand Surg. 1995; 29(2): 167–176.
- Fredrickson MJ, Kilfoyle DH. Neurological complication analysis of 1000 ultrasound guided peripheral nerve blocks for elective orthopaedic surgery: a prospective study. Anaesthesia. 2009; 64(8): 836–844.
- Jeng CL, Torrillo TM, Rosenblatt MA. Complications of peripheral nerve blocks. Reg Anesth. 1995; 20: 343–346.
- Rothschild L, Bern S, Oswald S, et al. Intravenous lipid emulsion in clinical toxicology. Scand J Trauma Resusc Emerg Med. 2010; 18: 51.
