Phenol injection of the sympathetic chain

Reid, William O.; Watt, Jonathan; Gray, Thomas

doi:10.1002/bjs.1800570111

Cited by 105 publications

(31 citation statements)

References 5 publications

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“…Use of a radiologically controlled percutaneous injection of phenol, a minimally invasive sympathicolysis, can be achieved while avoiding surgical intervention [20]. However, undesirable tissue damage may be caused by uncontrolled spread of the chemical agent, and there are significant uncertainties regarding the duration of therapeutic effects [8].…”

Section: Discussionmentioning

confidence: 99%

Retroperitoneoscopic lumbar sympathectomy for the treatment of plantar hyperhidrosis: technique and preliminary findings

Rieger

Pedevilla

2006

Surg Endosc

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Section: Discussionmentioning

confidence: 99%

Retroperitoneoscopic lumbar sympathectomy for the treatment of plantar hyperhidrosis: technique and preliminary findings

Rieger

Pedevilla

2006

Surg Endosc

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“…Reid et al (1970), using chemical sympathectomy, provided relief from rest pain in 76 per cent of their patients. However, Fyfe and Quin (1975) showed no improvement in symptoms of intermittent claudication using chemical sympathectomy.…”

Section: Discussionmentioning

confidence: 97%

“…Ninety patients had one block carried out on one side only, whilst 6 required two blocks on the same side and 30 patients had bilateral lumbar sympathetic blocks (Table I). Technique The lumbar sympathetic chain was injected at the level of the third and fourth lumbar vertebra using the technique described by Reid et al (1970). A swinging-arm image intensifier (Philips BV 21) was used to adjust the final position of the needles.…”

Section: Methodsmentioning

confidence: 99%

Phenol lumbar sympathectomy for severe arterial occlusive disease in the elderly

Keane

1977

Journal of British Surgery

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Phenol chemical lumbar sympathectomy is an additional aid in the management of ischaemic rest pain and incipient gangrene. This technique was used in 132 elderly patients in Bath between September 1972 and March 1975 and the results are presented here. The patients were unfit for reconstructive arterial surgery. In this series an image intensifier was used in order to make the procedure safer. One hundred and twenty-six patients were available for review, their average age being 71.5 years. The average period of follow-up was 16.3 months. Of the 126 patients, 111 were not diabetic, and of these 45 (41 per cent) had satisfactory results while 17 (15.4 per cent) had persistent symptoms but had avoided amputation. Thirty (27 per cent) patients required amputation and 12 of these died as a direct result of this procedure. A further 19 patients in the non-diabetic group died during the period of follow-up. However, of the 15 diabetic patients, only 3 (20 per cent) improved whilst one patient with persistent symptoms avoided amputation. The remainder either died (8) or had an amputation (5) during the period of follow-up. Two died after amputation.

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“…This may explain why sympathetic block sometimes relieves intermittent cla~dication. '~ , 14 However, sympathectomy may produce a 'steal' effect by diverting blood from the muscles to the skin. The effects of chemical sympathectomy are discussed in another comrn~nication.~~ Whatever the mechanism of action, paravertebral lumbar somatic nerve block, using phenol, is a simple method of the treatment for intermittent claudication when reconstructive surgery is not practicable, especially in old or debilitated patients.…”

Section: Discussionmentioning

confidence: 99%

Treatment of intermittent claudication

Feldman

Yeung

1975

Anaesthesia

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Intermittent claudication results from relative ischaemia of the muscles in the lower limb brought on by exercise. The ischaemia is usually due to obstruction of the femoral artery as a result of atherosclerosis. The ideal treatment of this condition is the removal of the obstruction, either by thrombo-endarterectomy, or by arterial reconstruction. Watt et al.' reported excellent results following arterial surgery in a highly selected series of relatively young patients. They achieved a high patency rate (95% on discharge, 60-70% in 5 years) with insignificant operative mortality but, in many patients with intermittent claudication, either poor general condition or unfavourable local vascular condition, precludes surgery; in Taylor's' series, only 63% of limbs were suitable for direct arterial surgery.

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Phenol injection of the sympathetic chain

Cited by 105 publications

References 5 publications

Retroperitoneoscopic lumbar sympathectomy for the treatment of plantar hyperhidrosis: technique and preliminary findings

Retroperitoneoscopic lumbar sympathectomy for the treatment of plantar hyperhidrosis: technique and preliminary findings

Phenol lumbar sympathectomy for severe arterial occlusive disease in the elderly

Treatment of intermittent claudication

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