Epidural neurolysis has been suggested for control of terminal pain due to malignancy (1), including recent use of serial daily phenol injections via a percutaneously placed epidural catheter (2). Racz et al. emphasized the use of a Racz (Arrow InteRNational Inc., Reading, PA) epidural catheter with an implanted coiled wire that was fluoroscopically advanced epidurally. This same catheter was then gradually withdrawn allowing small serial daily phenol injections along the neuraxis. The present case report describes a structural disruption that occurred in the epidural portion of a Racz catheter after implantation for phenol neurolysis. Fortunately, adequate analgesia followed the initial phenol injection, even though serial injections were planned. Catheter disruption was discovered fortuitously after removal of the catheter before any further injections were performed. Based upon our experience and previous difficulties with Racz catheters (3), a modification in the technique of serial phenol injections or retuRN to separate percutaneous epidural phenol injections is suggested.
Address correspondence to Dr. CooMDs, Department of Surgery, Section of Anesthesiology, Dartmouth-Hitchcock Medical Center, 2 Maynard Street, Hanover, NH 03756.
© 1985 International Anesthesia Research Society