Clinical Experience of the Phenol Block to the Cerebral Palsied Children
60 Cases
1973 Volume 10 Issue 1 Pages 33-38
Details
1973 Volume 10 Issue 1 Pages 33-38
60 casee of CP (spastic hemiplegia 3, spastic paraplegia 24, athetoid 7, mixed 3) were given the phenol block with 5% phenol solution to facilitate the training and nursing care. Motor branches of hypertonic muscles, which disturb the ambulation, the ADL, and the nursing care of CP, were searched by teflon coated needle connected with the portable type electrostimulator. At most 4 times of the block had done to one muscle group, when the recurrence had occured after phenol block.
Spastic pes equinus were treated by motor point blocks (19 times), or tibial nerve blocks (83 times) of the calf muscles. All of the motor point block had recurred within 3 months. However, the tibial nerve block could have long term of effectivenss. More than 6 months of the effective duration has been gotten in 10 time trials of tibial nerve blocks.
The obturator nerve blocks (42 times) were done to decrease the adductor spasticity, which distorted the gait of CP, and also disturbed the nursing care of severely crippled CP children. 28 times of the trial of obturator nerve blocks could have the long term of effectiveness. 19 times of them has been effective more than 6 months after the blocks.
4 cases of tension athetosis were treated by the block on thoracodorsal nerve, motor points of triceps brachii, and sciatic nerve to decrease the hypertonic state of the muscles. 1 case of them had the long term of effectiveness, and other 3 cases had the very short term of it.
Using the thin teflon coated needle to block the nerve trunk, for instance sciatic nerve, the target muscle would be blocked selectively. This comes from author's experience. Phenol block also had done to avoid second operation of Achilles tendon lengthening to correct pes equinus, and adductor tenotomy of the hip.
16 limbs got the phenol block of calf muscles to correct the recurred pes equinus after Achilles tendon lengthening. Three limbs also got the obturator nerve blocks to correct the recurred adductor spasticity following adductor tenotomy.
