Ultrasound-guided paravertebral neurolytic block: a report of two cases

Pain Pract. 2014 Apr;14(4):346-9. doi: 10.1111/papr.12072. Epub 2013 May 21.

Abstract

Paravertebral block is commonly used in the treatment for acute and chronic pain. The duration of paravertebral block could theoretically be prolonged with neurolytic agents. We report two cases of ultrasound-guided neurolytic paravertebral blocks in patients suffering from intense cancer-related thoracic pain. Ultrasound was used to identify the space and plane of injection at the mid-thoracic level. Absolute alcohol was used to block the nerves at different segments. The two patients had great pain relief. Neurolytic paravertebral block can be a useful technique in patients with intractable cancer pain. Because of the risk of complication, it is recommended that this technique should be limited to relief of intractable pain in cancer patients with a poor prognosis.

Keywords: alcohol; cancer pain; neurolytic block; paravertebral block; paravertebral space; ultrasound.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Ethanol / pharmacology
  • Female
  • Humans
  • Intercostal Nerves / physiology*
  • Intercostal Nerves / surgery
  • Male
  • Neoplasms / complications
  • Nerve Block / methods*
  • Pain Management
  • Pain, Intractable / etiology
  • Pain, Intractable / surgery*
  • Ultrasonography, Doppler*

Substances

  • Ethanol