Interventional techniques for the management of cancer pain. Part I. Neurodestructive procedures into the neuraxial space

The Pain Management Center specialist offers a wide range of treatment options, standard, conservative, and the most advanced surgical pain treatment. Many research studies confirm the therapeutic importance of interventional (surgical) cancer pain treatment and validity of use even in an advanced stage of the disease, especially in cases when pain is resistant to conservative pharmacological treatment. The article discusses selected interventional methods for the treatment of chronic pain, of spinal origin. Both neurodestructive techniques and intrathecal drug administration are described. In most cases their effectiveness is high, but they differ in safety profile and intensity of side effects. In part I, the techniques of subarachnoid and epidural chemical neurolysis, somewhat forgotten and rarely performed, mainly due to possible catastrophic side effects, are described. Basic neurolytic agents are alcohol and phenol. Phenol is not available on the pharmaceutical market, but can only be prepared by hospital pharmacies. The properties and uses of alcohol and phenol as well as side effects are compared. The third agent, glycerol, is applied only in the face area.