[The role of neurolytic therapy in blocking cancer pain]

Here is a presentation of the role played by neurolesive procedures in the management of cancer pain. The authors suggest that these procedures should be considered secondary to the analgesic drugs and should be used only in a very limited number of situations (20/25%) due to the changes in neurophysiology of nerve transmission, caused by these interventions. Open neurolesive surgical treatments have a restricted indication because they are very traumatizing and the risk-benefit ratio is scarcely positive. Generally the chemical and thermal neurolesive procedures which are more widely used are represented by: sacral subarachnoidal block, alcholization of celiac ganglion, thermorhyzotomy of Gasser's and percutaneous chordotomy. The limits and benefits of these procedures are discussed. The authors maintain that a single technique can never completely solve the problem of pain; it can give pauses from pain, which have to be integrated sooner or later by analgesic drugs, within a continuing care program.