A neurolytic block is a form of nerve block that involves the use of alcohol to damage the nerves to achieve pain relief. It involves injecting alcohol into the nerves to damage the nerves to stop the transfer of pain signals to the brain.
A neurolytic block is used to achieve long-term pain relief of areas in the torso such as the chest, back, and abdomen.
Patients diagnosed with advanced stages of various types of cancer such as colon cancer, gallbladder cancer, ovarian cancer, and pancreatic cancer may experience significant pain relief from a neurolytic block.
Neurolytic block injections differ from nerve block injections. While nerve block numbs the nerves to provide temporary pain relief, neurolytic block damages the nerve to provide long-term pain relief.
Neurolytic block prevents the long-term use of opioids and strong pain medications that could cause severe side effects.
Preparations for a Neurolytic Block
Before undergoing a neurolytic block, you may be asked to discontinue the use of certain medications such as blood thinners, for a few days to reduce the risk of bleeding.
Avoid taking anti-inflammatory medicines, such as ibuprofen or naproxen for 24 hours before your procedure.
Your doctor might have some specific instructions for you if you’re having a neurolytic block for a surgery. You may be asked not to eat or drink anything for 6-12 hours before your surgery.
Inform your doctor about any medications you’re currently taking or any allergies that you may have.
Arrange for someone that will take you home after the procedure because you won’t be allowed to drive after your procedure.
Indications for Neurolytic Blocks
- Anteroposteriorly mobile at the mid-brain level but unable to move the head.
- Has an ataxic gait, with an almost hop-like movement.
- Incontinent, requiring diapers.
- Immobile, unable to sit up or hold an object.
- Unresponsive to stimuli.
- Arouses quickly and does not respond to pain.
- Loss of bladder and bowel control.
- Difficulty swallowing.
- Difficulty breathing.
Benefits of neurolytic blocks treatment
The benefits of neurolytic block treatment are many, but the most important is that they work.
In most cases, patients will notice a reduction in their pain levels after treatment.
Neurolytic blocks are beneficial for the chronic pain that results from chemical, thermal, and radiation injuries.
Neurolytic blocks are also crucial for treating pain from injuries such as car accidents, surgery, illness, and sports injuries.
How a Neurolytic Block Procedure is done
A neurolytic block is administered in a similar way as a nerve block injection.
You will be asked to lie down on your stomach on an X-ray table. Your doctor will first clean the area where the needle will be inserted with an antiseptic solution. A topical anesthetic will also be used to numb the area so that you don’t feel pain.
Your doctor will then insert the needle with the use of fluoroscopy or ultrasound guidance to ensure that the needle is in the right position. Your doctor will then inject the medication containing alcohol or chemicals such as phenol to the target nerves to destroy the nerves.
When this is achieved, the nerves are unable to transfer pain signals to the brain, causing pain relief.
After Neurolytic Block Procedure
You may experience soreness in the injection site for a few days.
Neurolytic block injections are considered a long-term treatment and can provide pain relief for years. However, nerves may begin to repair themselves and regrow after several months or years. When the nerves grow back, the pain may return as the nerves begin to transfer pain signals again. It is also possible that the nerves won’t grow back.
Risks Associated with Neurolytic Blocks
Risks associated with neurolytic blocks may include:
- Bleeding at the injection site
- Bruising at the injection site
- Allergic reaction to the anesthetic used
Why neurolytic blocks are performed
Most neurolytic blocks are performed on patients with multiple sclerosis (MS), recent onset of Parkinson’s disease, or amyotrophic lateral sclerosis (ALS), a progressive paralytic disorder. The nerve cells that manage muscle movement and coordination die in these diseases.
A needle is inserted into the problematic area during a neurolytic block, and two chemicals are injected into the affected nerve. These chemicals block the effect of the nerve signals, and the patient can move his or her muscles again.
How long does a neurolytic block last?
The neurolytic block is the intravenous injection of a local anesthetic that also causes general muscle relaxation. The infusion lasts a few minutes and is used to maintain anesthesia while the surgical team performs a procedure.
When are neurolytic blocks indicated for pain management?
When a patient has a debilitating back or limb pain for which there are no other apparent causes, spinal cord stimulation may be the next step. Neurolytic blocks are typically used in patients who have severe or intractable pain that is not adequately controlled by one or more medications.