Atlas of Image-Guided Intervention in Regional Anesthesia by James P. Rathmell MD
By James P. Rathmell MD
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Extra resources for Atlas of Image-Guided Intervention in Regional Anesthesia and Pain Medicine
Perils of intravascular methylprednisolone injection into the vertebral artery. An animal study. J Bone Joint Surg Am. 2008;90:1932–1938. Patt RB, Cousins MJ. Techniques for neurolytic neural blockade. In: Cousins MJ, Bridenbough PO, eds. Neural Blockade in Clinical Anesthesia and Management of Pain. 3rd ed. Philadelphia, PA: JB Lippincott; 1998:1007–1062. Viscomi CM. Pharmacology of local anesthetics. In: Rathmell JP, Neal JM, Viscomi CV, eds. Requisites in Anesthesiology: Regional Anesthesia.
AHFS Drug Information 2004. Bethesda, MD: American Society of Health-System Pharmacists; 2004:2892–2919. Benzon HT, Chew TL, McCarthy RJ, et al. Comparison of the particle sizes of different steroids and the effect of dilution: a review of the relative neurotoxicities of the steroids. Anesthesiology. 2007;106:331–338. Dawley JD, Moeller-Bertram T, Wallace MS, et al. indd 32 transforaminal epidurals. Spine (Phila Pa 1976). 2009;34: 1638–1643. Horlocker TT, Wedel DJ, Rowlingson JC, et al. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Third Edition).
In contrast to alcohol, there is little or no pain on injection of phenol. The degree of neural blockade following injection of phenol is maximal in the first hours after injection and tends to subside somewhat thereafter. indd 30 Absolute (>98% concentration) ethyl alcohol is available commercially in 1- or 5-mL vials specifically for therapeutic neurolysis. Unlike phenol, alcohol injects readily through small-bore needles. Phenol causes intense pain when injected perineurally and must be preceded with local anesthetic or mixed directly with local anesthetic for injection to be tolerable to the patient.