frequent procedures
 

NEUROLYTIC LUMBAR SYMPATHETIC BLOCK
Neurolytic lumbar sympathetic block is similar to lumbar sympathetic block for the treatment of reflex sympathetic dystrophy of the lower extremities. The significant difference lies in the injection of phenol (6% or 10%) as opposed to a local anesthetic like 1% lidocaine. This procedure is usually carried out after a test treatment series has been completed with lumbar sympathetic block that shows that the patient does respond to local anesthetic injection into the lumbar sympathetic chain region in the region of the paravertebral and anterolateral portion of the lumbar vertebrae. The injection is done carefully after confirmation is done with a contrast material (dye) and is frequently done with phenol solution on the ipsilateral side using approximately 6-10cc depending on the patient’s size. The effect is to achieve dehydration and therefore inference with the lumbar sympathetic chain that control the affected lower extremity resulting in long-term pain relief. This is preceded by increase in temperature of the lower extremity concerned, increase in blood flow, and should as in all cases be followed by physical therapy and other rehabilitation measures to achieve optimal results.

Contraindications: Care should be taken in patients who have aortic aneurysm that may be present in the abdomen or patients who are prone to infection because of low T cell count as may be found in immuocompromised patients in general. This may include chronic diabetics, patients on chronic dialysis, or patients with HIV/AIDS, to name a few. Patients on Coumadin or anticoagulation are also a relative contraindication, since this can be discontinued to allow the procedure to be done, and then restarted thereafter.

Complications: Complications in this clinical situation include blood vessel puncture and hematoma or intravenous injection of phenol infection, and peritonitis.

Sedation: This is not usually required
 

<< Back To Procedure List