Percutaneous-guided pain control: exploiting the neural basis of pain sensation

Gastroenterology Clinics of North America
Michael D Adolph, Costantino Benedetti

Abstract

The gastroenterologist deals frequently with painful conditions and suffering patients. Performing regular pain assessments and applying basic pain medicine principles will augment the care of patients in pain. Percutaneous-guided pain therapy techniques play a role in the multidisciplinary approach to pain medicine. Systemic opioid analgesia is the primary means of controlling cancer pain. However, 10% to 15% of cancer patients may need additional interventions to control pain. Sympathetic ganglion nerve blocks with neurolytic agents such as alcohol or phenol are reserved mostly for cancer pain. The efficacy and safety of these tools are validated by several decades of clinical application and published studies. Although the procedures are operator-dependent, in the hands of experienced clinicians, patients achieve sustained relief in the majority of cases. Although these techniques have been attempted in some benign conditions,such as chronic pancreatitis, with limited success, studies of newer imaging localization techniques such as endoscopic ultrasonography may expand future indications. Patients of the gastroenterologist who experience malignant abdominal pain may benefit from referral for percutaneous-guided pain control...Continue Reading

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Citations

Dec 7, 2007·Anesthesiology Clinics·John D Markman, Annie Philip
Jun 5, 2007·Best Practice & Research. Clinical Gastroenterology·David G Thompson
Feb 27, 2007·The Medical Clinics of North America·John D Markman, Annie Philip

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