22nd Annual Pain Medicine Meeting 2023

Neurolytic Adductor Canal Block for the Management of Intractable

Cancer Pain

Zohal Sarwary1, Neil Raj Singhal MD2, Mariam Sarwary MD3, Sean J. Gamble MD2

Creighton University School of Medicine- Phoenix, AZ1;Phoenix Children’s Hospital, Department of Anesthesiology and Pain Medicine2; Stanford University, Department of Anesthesiology, Perioperative & Pain Medicine3

Introduction

15-20% of cancer patients have intractable pain despite increasing
Phenol injections can be used for neurolysis of key peripheral nerves to
aid with cancer pain. 2
Presenting a case of an 11 y.o female with hx of AML in remission who came to pain clinic with hx of bilateral distal femur osteonecrosis due to Graft versus Host Disease (GvHD). Patient was wheelchair bound secondary to pain despite attempts at multimodal analgesia and increasing opiate requirements.

Methods

Patient and family were consented for risks and benefits of phenol injection, including loss of sensation in the described distribution.
A preliminary block using 0.2% ropivacaine was done to ensure adequate effect. The patient received a right sided iPACK block followed by a right sided adductor canal nerve block after which she was able to stand up and jump on one leg. The left side was similarly blocked with the same effect.
Patient then presented for bilateral adductor canal blocks under general anesthesia. 4 mL of 6% phenol was injected at each site.

22nd Annual Pain Medicine Meeting 2023

NEUROLYTIC ADDUCTOR CANAL BLOCK FOR THE MANAGEMENT OF INTRACTABLE CANCER PAIN

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