From the Department of Anesthesiology, Grand Strand Regional Medical Center, Myrtle Beach, South Carolina, and Graduate Medical Education, HCA Healthcare, Nashville, Tennessee.
A A Pract. 2021 Mar 8;15(3):e01416. doi: 10.1213/XAA.0000000000001416.
A 78-year-old man with uncontrolled diabetes, heart failure, and hemodialysis-dependent end-stage renal disease presented with intractable penile pain secondary to calciphylaxis and necrosis of his glans penis. Given pain refractory to pharmacologic management and refusal of surgery, treatment entailed an ultrasound-guided dorsal penile nerve block with 5 mL of aqueous 4% phenol bilaterally. The patient reported immediate relief and died pain-free 3 months later. While phenol nerve blocks are increasingly uncommon due to local tissue toxicity, the precision of ultrasound leverages phenol's denaturing and axonal demyelinating properties to facilitate long-term targeted neurolysis to palliate chronic nonmalignant pain.
一位 78 岁的男性，患有未控制的糖尿病、心力衰竭和依赖血液透析的终末期肾病，因钙磷沉积症和龟头坏死导致阴茎剧烈疼痛而就诊。由于药物治疗无效且拒绝手术，采用超声引导双侧阴茎背神经阻滞，共 5 毫升 4%苯酚水溶液。患者即刻缓解，并在 3 个月后无痛死亡。尽管由于局部组织毒性，苯酚神经阻滞的应用越来越少见，但超声的精准性利用了苯酚的变性和轴突脱髓鞘特性，以促进长期靶向神经松解，从而缓解慢性非恶性疼痛。
