1. A Study to Evaluate the Effectiveness of Phenol Blocks to Peripheral Nerves in Reducing Spasticity in Patients with Paraplegia and Brain Injury
- Author
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Kumar ER, Venugopal K, Tharion G, and Bhattacharji S
- Subjects
Phenol block ,spasticity ,spinal cord injury ,H reflex ,Medicine - Abstract
Primary objective: To evaluate effectiveness of phenol blocks of peripheral nerves in reducing spasticitybrain injured and spinal cord injured patients.Secondary objectives: To measure the change in the range of motion after phenol blocks to peripheralnerves, to identify the electrophysiological changes and to study the cost effectiveness and side effects ofphenol blocks.Study design: Descriptive studySetting: Tertiary referral centre, India.Methods: This study was conducted from March 2000 to January 2002 among 20 patients with spasticity.Spasticity was measured by modified Ashworth scale and range of motion was measured with a standardgoniometer on 1st, 7th, 14th and 21st days of the study. Nerve conduction studies, gait analysis, and functionalindependence measure was measured on 1st and 21st day of the study. Nerve blocks were done on 7th and14th day of the study with 0.5% bupivacaine and 6% phenol in water respectively.Results: 20 patients were included in the study, out of which 85% had spinal cord injury and 15% patientshad brain injury sequelae. Spasticity measured by modified Ashworth scale, showed a statistically significantreduction with neurolysis. Following obturator neurolysis abduction of hip joint improved significantly andwith posterior tibial neurolysis there was significant improvement in dorsiflexion and plantar flexion rangeof the ankle joint. Functional improvement measured with the FIM score also showed statistically significantimprovement after neurolysis. H reflex amplitude was significantly reduced following neurolysis. Therewas a statistically significant reduction in the consumption of systemic medications for spasticity followingthe injection.Conclusion: Range of motion in neighboring joints improved significantly after blockade of spasticity usingPhenol neurolysis. There was statistically significant reduction in the amplitude of the H reflex. Therewere no major adverse effects following neurolysis with phenol and it was found to be significantly costeffective when compared to systemic antispastic medications.
- Published
- 2008