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Neurolytic Blocks

What are Neurolytic Blocks?

A neurolytic block is a form of nerve block injection that utilizes phenol or alcohol to deliberately damage nerves and accomplish pain relief. This form of injection is utilized particularly to accomplish long-term pain relief of segments in the trunk of the human body. Contrary to nerve blocks, neurolytic blocks are not employed to manage pain in the legs, feet, hands, or arms. Neurolytic block injections vary from conventional nerve block injections in that they focus on destroying nerve fibers transmitting pain, rather than numbing them for short-term pain relief.

Also, focused amounts of cold (cryoablation) or heat (radio-frequency lesioning) may be utilized to destroy the painful nerve fibers.

Indications for Neurolytic Blocks

Neurolytic blocks are mainly indicated for the treatment of cancer pain not responsive to other treatment modalities in individuals diagnosed with advanced stages of several types of cancer, such as:

  • Pancreatic cancer
  • Ovarian cancer
  • Gallbladder cancer
  • Colon cancer
  • Stomach cancer
  • Liver cancer

Preparation for Neurolytic Blocks

Pre-procedure preparation for neurolytic blocks will involve the following steps:

  • A thorough examination is performed by your doctor to check for any medical issues that need to be addressed prior to the procedure.
  • Depending on your medical history, social history, and age, you may need to undergo tests such as blood work and imaging to help detect any abnormalities that could threaten the safety of the procedure.
  • You will be asked if you have allergies to medications, anesthesia, or latex.
  • You should inform your doctor of any medications, vitamins, or supplements that you are taking.
  • You may need to refrain from vitamins and supplements or medications such as blood thinners for a week or two prior to the procedure.
  • You should refrain from alcohol or tobacco at least a few days prior to the procedure.
  • You should not consume any solids or liquids at least 8 hours prior to the procedure.
  • You should arrange for someone to drive you home after the procedure.
  • A written consent will be obtained from you after the procedure has been explained in detail.

Procedure for Neurolytic Blocks

A neurolytic block procedure takes about an hour to complete and you may go home the same day. It is administered in a manner similar to a nerve block injection, where real-time x-ray images are utilized to guide the physician.

In general, the procedure involves the following steps:

  • You will lie face down on an x-ray table so that your physician can access the region of the spine where the injection will be administered.
  • Your physician will clean the region where the medication will be injected utilizing an antiseptic solution.
  • Your physician will then apply a topical anesthetic to numb the region.
  • Under real-time x-ray guidance, your physician determines the specific area needing treatment and injects the medicine to the appropriate nerves in the spine.
  • The needle is removed and a bandage is applied to the treatment site.

Post-procedure Care and Recovery

In general, post-procedure care instructions and recovery after neurolytic blocks will involve the following steps:

  • You will be transferred to the Postanesthesia Care Unit (PACU) where your nurse will closely observe you for any allergic/anesthetic reactions and monitor your vital signs as you recover.
  • You may feel nauseous and drowsy once you are awake from anesthesia. 
  • You may experience pain and soreness in the treatment area for a few days. Pain and anti-inflammatory medications are prescribed as needed.
  • Refrain from operating heavy machinery or driving for at least 24 hours.
  • Refrain from consuming alcohol for at least 24 hours.
  • You will be able to shower the very next day of the procedure.
  • You will be able to resume your normal activities within a couple of days but may have certain activity restrictions.
  • A follow-up visit will be scheduled to monitor your progress.

Risks and Complications

A neurolytic block is a relatively safe procedure; however, as with any procedure, some risks and complications may occur, such as:

  • Infection
  • Bleeding
  • Pain
  • Damage to adjacent tissue
  • Soreness or bruising
  • Allergic/anesthetic reactions