Neurolytic blocks: When, how, why

Girişimsel teknikler nöroablatif ve nöromodülatör işlemler olarak iki gruba ayrılırlar. Nöroablasyon, cerrahi, kimyasal veya ısı uygulamalarıyla ağrı yolaklarında fiziksel iletinin kesilmesidir. Nöromodülasyon, stimülasyon uygulamasıyla veya intraventriküler ya da intraspinal uygulanan opioidler ve diğer ajanlarla ağrı yolaklarının dinamik ve fonksiyonel inhibisyonudur. Nöroablatif teknikler kanser tedavisinde yüzyıldan fazla zamandır kullanılmaktadır. Fluroskopi gibi görüntüleme araçlarındaki gelişmelerle nöroablatif uygulamalar daha doğru ve etkili bir şekilde gerçekleştirilmektedir.

Nörolitik bloklar: Ne zaman, nasıl, niçin

Interventional techniques are divided into two categories: neuroablative and neuromodulatory procedures. Neuroablation is the physical interruption of pain pathways either surgically, chemically or thermally. Neuromodulation is the dynamic and functional inhibition of pain pathways either by administration of opioids and other drugs intraspinally or intraventricularly or by stimulation. Neuroablative techniques for cancer pain treatment have been used for more than a century. With the development of imaging facilities such as fluoroscopy, neuroablative techniques can be performed more precisely and efficiently.

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1. World Health Organization. Cancer as a global problem. Weekly epidemiological record 1984;59:125-6.
2. World Health Organization. Cancer Pain Relief. 2nd ed. Geneva: World Health Organization; 1989.
3. World Health Organization. Cancer Pain Relief. Geneva: World Health Organization; 1986.
4.Grond S, Zech D, Schug SA, Lynch J, Lehmann KA. Validation of World Health Organization guidelines for cancer pain relief during the last days and hours of life. J Pain Symptom Manage 1991;6(7):411-22.
5. Takeda E. Results of i eld-testing in Japan of WHO draft interim guidelines on relief of cancer pain. The Pain Clinic 1986;1:83-9.
6. Fitzgibbon DR. Cancer pain: assessment and diagnosis. In: Loeser JD, editor. Bonica’s management of pain 3rd ed. Philadelphia: Lippincott, Williams & Wilkins; 2001. p. 623-58.
7. Hartel E. Die Leitungsanesthesie und Injektionsbehandlung des Ganglion Gasseri und der Trigeminusaeste. Arch Klin Chir 1912;100:193-292.
8. Sweet WH, Wepsic JG. Controlled thermocoagulation of trigeminal ganglion and rootlets for dif erential destruction of pain fibers. 1. Trigeminal neuralgia. J Neurosurg 1974;40(2):143-56.
9. Håkanson S. Trigeminal neuralgia treated by the injection of glycerol into the trigeminal cistern. Neurosurgery 1981;9(6):638-46.
10. Taha JM, Tew JM Jr. Comparison of surgical treatments for trigeminal neuralgia: reevaluation of radiofrequency rhizotomy. Neurosurgery 996;38(5):865-71.
11. Labat G. Regional Anesthesia: It’s Technic and Clinical Application. Philadelphia: WB Saunders; 1922.
12. Dogliotti AM. Traitement des syndromes douloureux de la peripherie par 1’ alcoolisation sus-arachnoidienne des racines posterieures a leur emergence de la moelle epiniere. Presse Med 1931;39:1249-54.
13. Hay RC. Subarachnoid alcohol block in the control of intractable pain: report of results in 252 patients. Anesth Analg 1962;41:12-6.
14. Swerdlow M. Subarachnoid and extradural block in pain relief. In: Swerdlow M, editor. Relief of Intractable Pain. 3rd ed.Amsterdam: Elsevier Scientii c; 1984.
15. Ferrer-Brechner T. Epidural and intrathecal phenol neurolysis for cancer pain: review of rationale and techniques. Anesth Rev 1981; 8: 14-20.
16. Morrica G. Chemical hypophysectomy for cancer pain. In: Bonica JJ, editor. Advances in Neurology. Vol. 4. Pain. New York: Raven Press; 1974. p. 707-14.
17. Butler SH, Charlton JE. Neurolytic blockade and hypophysectomy. In: Loeser JD, editor. Bonica’s Management of Pain. 3rded. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 1967-2006.
18. Bonica JJ. Sympathetic Nerve Blocks for Pain Diagnosis and Therapy: Fundamental considerations and clinical applications. Vol. 1, New York: Breon Laboratories; 1984.
19. Kappis M. Weitere Erfahrungen mit der Sympathektomie. Klin Wehr 923;2:1441.
20. Brumm F, Mandl E. Die Paravertebrale Injektion zur Bekaempfung Visceraler Schmerzen. Wien Klein Aschsch 1924;37:511.
21. Raj PP, Lou L, Erdine S, Staats PS, Waldman SD. Radiographic Imaging for Regional Anesthesia and Pain Management. Philadelphia; Churchill Livingstone; 2003. p. 72-80.
22. Kappis M. Erfahrungen mit Lokalanasthesie bei Bauchoperationen. Verb Dtsch Ges Circ 1914;43:87.
23. Singler RC. An improved technique for alcohol neurolysis of the celiac plexus. Anesthesiology 1982;56:137.
24. Raj PP. Chronic pain. In: Raj PP, editor. Handbook of Regional Anesthesia. New York: Churchill Livingstone; 1985. p. 102-16.
25. Mercadante S, Nicosia F. Celiac plexus block: a reappraisal. Reg Anesth Pain Med 1998;23(1):37-48.
26. Patt RB, Cousins MJ. Techniques for neurolytic neural blockade. In: Cousins MJ, Bridenbaugh PO, editors. Neural Blockade in Clinical Anesthesia and Management of Pain. 3rd ed. Philadelphia: J.B. Lippincott; 1998. p. 1007-61.
27. Jaboulay M. Le traitement de la nevralgie pelvienne par paralyse due sympathique sacre. Lyon Med 1899;90:102.
28. Ruggi G. Della sympathectomy mia al collo ed ale abdomen.Policlinoico 1899;103.
29. Plancarte R, Amescua C, Patt RB, Aldrete JA. Superior hypogastric plexus block for pelvic cancer pain. Anesthesiology 1990;73(2):236-9.
30. Plancarte R, Amescua C, Patt RB, Allende S. Presacral blockade of the ganglion of Walther (ganglion impar). Anesthesiology 1990;73:A751.
31. Mullan S, Hekmatpanah J, Dobben G, Beckman F. Percutaneous, intramedullary cordotomy utilizing the unipolar anodal electrolytic lesion. J Neurosurg 1965;22(6):548-53.
32. Rosomof HL, Brown CJ, Sheptak P. Percutaneous radiofrequency cervical cordotomy: technique. J Neurosurg 1965;23(6):639-44.
33. Uematsu S. Percutaneous electrothermocoagulation of spinal nerve trunk, ganglion and rootlets. In: Schmidel HH,Sweet WS, editors. Current Techniques in Operative Neurosurgery. New York: Grune and Stratton; 1977. p. 469-90.