Relief of intractable pain from metastatic multiple myeloma using epidural phenol injections

Abstract

Neurolytic techniques arc often not used until late in the course of the patient's disease due to fear of the potential complications. Ncurolysis may be vcry valuable, however, for the patient whose opioid dose has been escalated to levels that produce severe side effects without providing analgesia. Intrathecal neurolysis with alcohop and phenol 2-5 is a well-accepted means for thc trcatment of patients with intractahlc malignant pain, and cpidural neurolysis, either with alcohol6, 7 or phenol,a, 9 has also been used in the cancer population. Epidural neurolysis may allow bettcr localization of the affected region than the intrathecal route, a We report a case in which epidural phenol was used to treat intractable pain in a patient with multiple myeloma and paraplegia.