A safer step-by-step approach for erector spinae plane phenol neurolytic blocks

In reply: A safer step-by-step approach for erector spinae plane phenol neurolytic blocks

“…While I have no doubt that the efficacy of a phenol neurolytic erector spinae plane block (ESPB) is clearly shown in their case, 1 as well in previous publications, the limited number of case reports makes it difficult to draw confident conclusions regarding safety. As the authors themselves stated in one of their reports, ''definitive evidence of safety of ESPB as a neurolytic block will require randomized clinical trials''.…”

“…I read with interest the comments by Dr. Rocha-Romero et al, 1 in response to our article entitled ''Safety of neurolytic erector spinae plane blocks for cancer pain''. 2 The authors point to some interesting issues that I would like to respond to.…”

“…Rocha-Romero et al also evoked the similarity with treating facet joint pain with radiofrequency ablation (RFA) as an argument to reduce concerns about any potential negative effects of a neurolytic ESPB on the dorsal rami. 1 Using RFA offers the advantage of precision, which provides a considerable safety margin. Indeed, accurate placement of RFA needles is paramount and requires a thorough knowledge of the target and associated radiographic landmarks to avoid ablating the wrong nerve elements.…”

Procedimientos intervencionistas en el tratamiento del dolor oncológico

“…Existen reportes de estos a nivel del Plano transverso del abdomen. Bloqueo TAP neurolítico [16] y a nivel del plano del Erector de la Espina tanto a nivel toráccico como abdominal [17], [18]. Estos procedimientos requieren aún de mayor número de publicaciones para evaluar su verdadera efectividad y seguridad.…”

Ultrasound-guided preperitoneal phenol neurolysis for palliative pain

“…Two weeks later, the pain returned in the same way. Given the patient’s advanced malignancy and fragile condition, and based on previous publications supporting this approach,[ 3 4 ] a neurolytic block was discussed to avoid more patient interventions and exposure, particularly during COVID times. This time, a total volume of 10 mL of 10% aqueous phenol solution was injected in fractional doses of 1 mL per minute on each side.…”