Subarachnoid Alcohol Block in the Management of Pain of Malignant Disease

Subarachnoid alcohol block is a method meriting the attention of every physician who wishes to control the pain in patients with malignant disease.

In the 1930's, initial reports describing the technique and indications for the procedure were made by Dogliotti,⁸ Abraham,² Pitts,²⁷ Groff,¹⁵ Owings,²⁴ Saltzstein,³¹ and Stern.^32,33 At the same time, papers by Olmsted²² and Labat¹⁸ outlined the mechanism of the action of the alcohol on the nerves.

However, serious complications resulted from the use of subarachnoid alcohol block,^{4,6,11,23,26,36} and it was difficult to obtain analgesia for longer than six weeks. Therefore, after this period, neurosurgical measures (rhizotomy, tractotomy, lobotomy, etc.) were used to a greater extent than previously to control pain caused by malignant lesions. Table 1 summarizes the significant publications dealing with alcohol block over the past 20 years.

Recently the literature has reflected a new trend, a