Interventional Pain Medicine

Interventional pain medicine may be a subspecialty of the medicine, pain management, dedicated to the employment of invasive techniques like aspect joint injections, nerve blocks (interrupting the flow of pain signals on specific nervous pathways), neuro augmentation (including peripheral nerve stimulation), vertebroplasty, kyphoplasty, nucleoplasty, percutaneous spine fusion and implantable pain drug delivery systems. Radiotherapy is employed once drug treatment is failing to regulate the pain of a growing tumor, like penetration of soft tissue, or compression of sensory nerves. Often, low doses are capable of producing analgesia thought to be due to reduction in pressure or, possibly, interference with the tumor's production of pain-promoting chemicals. A neurolytic block is that the deliberate injury of a nerve by the appliance of chemicals (in that case the procedure is termed "neurolysis") or physical agents like freezing or heating ("neurotomy"). These interventions cause degeneration of the nerve's fibers and temporary interference with the transmission of pain signals. Delivery of an opioid like fentanyl, sufentanyl or meperidine directly into the subarachnoid cavity provides increased enhanced analgesia with reduced general aspect effects, and has reduced the amount of pain in otherwise intractable cases.Epidural infusion is suggested with long run use in order to reduce the prospect of any infection at the exit site reaching the epidural area Ongoing electrical stimulation of structures deep within the brain – the periaqueductal gray and periventricular gray for nociceptive pain, and the internal capsule, ventral posterolateral nucleus and ventral posteromedial nucleus for neuropathic pain – has produced impressive results with some patients but results vary and appropriate patient selection is important.

  • Neurolytic block
  • Intrathecal infusion
  • Epidural infusion
  • Deep brain stimulation

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