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Early Anesthesia and the Practice of Alcohol Injection
Austin Barnes
“Her doctors tried in vain to ease the suffering…Eventually one tried injecting pure alcohol into
her spine.” (Skloot, 2010)
Skloot, R. (2010). The immortal life of Henrietta Lacks. New York: Crown Publishers.
Abstract:“Moricca's technique of the injection of alcohol has been performed 155 times on 92
patients at the Centre for Pain Relief, Walton Hospital, Liverpool. There were 4 post-operative
deaths within the first week.
The technique is considered to be an exceedingly useful method of reviewing pain in patients
suffering from widespread inoperable cancer. 40% of the patients treated had complete relief of
their pain, half of these (20%) having complete relief for at least 4 months. 30% of the patients
treated had some relief of pain and 30% had none.
During injection, it was noted that Myodil injected before the alcohol spread along the pituitary
stalk and the walls of the third ventricle. It eventually broke through into the third ventricle. It is
postulated that the alcohol follows this route and the relief of pain is due to destruction of
thalamic and hypothalamic nerve pathways.”
Lipton, S., Miles, J., Williams, N., & Barkjones, N. (1978). Pituitary Injection Of Alcohol For
Widespread Cancer Pain.Pain, 5(1), 73-82.
This source is credible because the article was published through a hospital where this
anti pain technique was used many times. Research and hands on uses with this anesthetic have
occurred many times. It has also been cited by 39 people.
Abstract: “The technique of "chemical hypophyscctomy" was modified for the management of
pain due to metastatic cancer. Using stereotaxic control, a needle is introduced via the nose into
the sella turcica. Absolute alcohol is then injected into the pituitary. Of 13 patients who had
severe uncontrollable pain, 11 obtained marked symptomatic relief. The longest follow-up period
to date is seven months, with results persisting. Sequelae are those associated with destruction of
the pituitary gland, the most significant being diabetes insipidus. Several cerebrospinal fluid
leaks prompted us routinely to instill alpha-ethyl cyanoacrylate to seal the sella floor. Three
patients had slight extraocular nerve palsies. There was no death related to the procedure.”
Katz, J., & Levin, A. B. (1977). Treatment Of Diffuse Metastatic Cancer Pain By Instillation Of
Alcohol Into The Sella Turcica. Anesthesiology, 46(2), 115, 120.
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This article is reputable because of the journal it was printed in. It was printed in
Anesthesiology the Journal of the American Society of Anesthesiologists, which is a reputable
and trust worthy source.
Abstract: “Background: Celiac plexus neurolysis, a chemical splanchnicectomy of the celiac plexus, is used to treat
caused by pancreatic cancer. Most commonly, celiac plexus neurolysis is performed
percutaneously under CT or fluoroscopic guidance, but can also be performed with EUS. The
aim of this study was to prospectively assess the efficacy of EUS celiac plexus neurolysis in the
management of pain caused by pancreatic cancer. Methods: In this prospective study conducted
in a community-based referral hospital, 58 patients with painful and inoperable pancreatic cancer
were evaluated at 8 observation points before and after EUS celiac plexus neurolysis for up to 6
months. The following data were collected: age, gender, tumor location, vascular invasion,
adjuvant therapy, and laboratory tests including prothrombin time, and complete blood counts
were obtained at baseline (before EUS celiac plexus neurolysis); pain scores, morphine use, and
adjuvant therapy were assessed at each observation. Results: Pain scores were lower (p =
0.0001) 2 weeks after EUS celiac plexus neurolysis, an effect that was sustained for 24 weeks
when adjusted for morphine use and adjuvant therapy. Forty-five of the 58 patients (78%)
experienced a decline in pain scores after EUS celiac plexus neurolysis. Chemotherapy with and
without radiation also decreased pain after EUS celiac plexus neurolysis (p = 0.002). Procedurerelated transient abdominal pain was noted in 5 patients; there were no major
complications. Conclusions: EUS celiac plexus neurolysis is safe and controls pain caused by
unresectable pancreatic cancer. (Gastrointest Endosc 2001;54:316-24.)”
pain
Gunaratnam, N., Sarma, A., Norton, I., & Wiersema, M. (2001). A Prospective Study Of EUSguided Celiac Plexus Neurolysis For Pancreatic Cancer Pain.Gastrointestinal
Endoscopy, 54(3), 316-324.
This article is legitimate because it has been cited by over 200 different people and or research
teams. Also, it was written by a few doctors that have used this technique so it has hands on
insight and it was pier reviewed.
I learned a lot about early anesthesia, I was a little confused about the reason for injecting
straight alcohol into the spine and apparently it is a last resort. Sometimes it kills pain but it’s a
temperamental process and may cause detrimental side effects..
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This diagram shows how alcohol injections are
done.
Running header: One day research paper
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