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
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- EP ID EP279983
- DOI 10.14260/jemds/2017/1496 ss
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