EFFECTIVENESS OF PHENOL BLOCK IN THE MANAGEMENT OF SPASTICITY IN HEMIPLEGIA- A NONRANDOMISED CONTROLLED TRIAL
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 94
Abstract
BACKGROUND Peripheral nerve blocks have been shown to be an effective way of reducing spasticity. Phenol above 3% causes protein denaturation and axonal degeneration. Alcohol also causes tissue destruction such as nerve coagulation and muscle necrosis by denaturing proteins. Both are used in the management of gastroc-soleus spasticity, mainly by blocking the nerve supply to the gastrocnemius muscle. The objectives of the study was to determine the effectiveness of 3% phenol block of the motor branches of posterior tibial nerve to the gastrocnemius muscles in the management of gastroc-soleus spasticity in hemiplegic patients. MATERIALS AND METHODS All hemiplegic patients aged 35 to 65 years with spasticity of gastroc-soleus grade 3 attending Physical Medicine and Rehabilitation, Regional Institute of Medical Sciences, Imphal were included in the study. Motor branches of the posterior tibial nerve to the gastrocnemius muscles were blocked with injection 3% phenol in the intervention group and 50% alcohol in control groups respectively. The spasticity was measured by using Modified Ashworth Scale (MAS) score. Followup was done at 1, 3 and 6 months. The data was analysed by using IBM SPSS Statistics for Windows, Version 21.0, Armonk, NY. Chi-square test, MannWhitney U test and Friedman’s test were used to test for significance with p-value < 0.05 taken as significant. Study Design- Non-Randomised controlled trial. Study Setting- Department of Physical Medicine and Rehabilitation, Regional Institute of Medical Sciences, Imphal. RESULTS At the end of first, follow-up grade 3 spasticity was seen only in 2.8% in the intervention group and 8.6% in the control group. In the 2nd follow-up there was no case of grade 3 spasticity in the intervention group, but was seen only in 2.8% in the control group. In the 3rd follow-up, proportion of patients with spasticity grade 3 was increased to 40% in the control group. However, there were no cases in the study group. CONCLUSION Alcohol and phenol block of gastrocnemius muscles in hemiplegic patients for the management of gastrocnemius spasticity was found to be effective, but long-lasting effects were found more in the phenol block.
Authors and Affiliations
Taha Peya, Yumnam Ningthemba Singh, Naorem Bimol, Tamphaleima Khuraijam, Nandabir Singh, Akoijam Joy Singh
Keywords
Related Articles
- EP ID EP279983
- DOI 10.14260/jemds/2017/1496 ss
- Views 105
- Downloads 0
PORT SITE COMPLICATIONS IN LAPAROSCOPIC SURGERY
BACKGROUND Laparoscopic surgery is a new technique that has revolutionised the approach to surgery over the last two decades. However, it also has some demerits. Though the incidence is very low, port site comp...
ISOLATED TESTICULAR TUBERCULOSIS: A DUBIOUS FACADE
BACKGROUND Isolated testicular tuberculosis is a bizarre entity and it can present with atypical clinical features and its radiological signs remain elusive. Owing to its unusual occurrence and presentation, it...
CORRELATION BETWEEN SEVERITY OF ALCOHOL DEPENDENCE WITH AGE OF ONSET AND FAMILY HISTORY AMONG URBAN ALCOHOLICS: A CROSS-SECTIONAL STUDY
BACKGROUND A potentially powerful predictor of progression to alcohol-related harm is age at first use. Evidence suggests that the earlier the age at which young people take their first drink of alcohol, the gr...
COMPARATIVE STUDY OF THE LUNG VOLUME INCLUDED IN THE TANGENTIAL FIELD IN BODY CONTOUR BASED AND CT SCAN BASED 2-DIMENSIONAL RADIATION PLANNING IN BREAST CANCER TREATMENT
BACKGROUND Pneumonitis and lung fibrosis are some of the major toxicities of radiation in carcinoma breast, and the volume of lung included in radiation field should be as less as possible. One of the limitations of body...
A STUDY OF RELATION BETWEEN SYMPTOMS AND FEV1 (FORCED EXPIRATORY VOLUME IN ONE SECOND) IN PATIENTS WITH COPD AND BRONCHIAL ASTHMA
BACKGROUND To study the background, clinical manifestations and relation between clinical symptoms and FEV1 (Forced Expiratory Volume in one second) in patients with chronic obstructive pulmonary disease and bronchial as...