Phenol neurolysis for severe chronic nonmalignant pain: is the old also obsolete?

Objective: Our purpose was to reassess the effectiveness of phenol 4% in aqueous solution for neurolysis in patients with severe chronic nonmalignant pain syndromes who did not achieve adequate pain control (visual analog scale [VAS]
Design: Forty-two patients with severe nonmalignant pain persisting for 6 months or longer were followed for more than 6 months after phenol neurolysis in this prospective observational study. All patients had previously received narcotic drugs, with or without nonsteroidal anti-inflammatory agents or adjuvants, without adequate pain relief. An aqueous solution of phenol 4% was used for chemical neurolysis. A fluoroscopically guided technique was used for chemical lumbar sympathectomy, medial branch destruction, and sacroiliac injections. Anatomic-landmarks technique was used for intercostal neurolysis, greater occipital nerve destruction, genitofemoral neuroablation, and paracoccygeal infiltration.

Results: Good pain relief (VAS
Conclusion: The use of phenol 4% in aqueous solution is an effective and safe technique for neurolysis. Because of the potential risk of flaccid paralysis, this technique should be used in selected cases, far removed from motor nerves and the spinal cord.