Every thing you wanted to know about glycerine*
*But was afraid to ask
Every thing you wanted to know about glycerine*
*But was afraid to ask
Dr. G.V. LafargueDr. G.V. Lafargue
• October 4, 1836, he began the era of subcutaneous
• peripheral nerve injections.
• Cured his own arm neuralgia with 13 lancet injections.
• Used aqueous morphine powder.
• Letter-Dr. LaFargue-inoculation of morphine with the lancet. Bull. Acad. Med. Paris
Reterogasserian glycerol injection therapy in trigeminal neuralgiaReterogasserian glycerol injection therapy in trigeminal neuralgia Reterogasserian glycerol injection therapy in trigeminal neuralgiaReterogasserian glycerol injection therapy in trigeminal neuralgia
552 patients treated with a single injection. 59.1% pain-free-2 years
Complications were few and not incapacitating.
Conclusion: The technique-safe, cheap and effective in treating trigeminal neuralgia.
S Saini et al
552 patients treated with a single injection. 59.1% pain-free-2 years
Complications were few and not incapacitating.
Conclusion: The technique-safe, cheap and effective in treating trigeminal neuralgia.
S Saini et al
For spider veins, glycerin was more effective than polidocanol.
Samer Alaiti, MD,
Other doctors use 1% glycerin with lidocaine
For spider veins, glycerin was more effective than polidocanol.
Samer Alaiti, MD,
Other doctors use 1% glycerin with lidocaine
Sclerotherapy Treatment & Management
Pain and dermal reaction caused by injected Pain and dermal reaction caused by injected glycerin in immunotherapy solutions glycerin in immunotherapy solutions
Pain and dermal reaction caused by injected Pain and dermal reaction caused by injected glycerin in immunotherapy solutions glycerin in immunotherapy solutions
Injected glycerin produces pain that is proportional to total injected dose of glycerin,
Van Metre TE Jr, Rosenberg GL, Vaswani SK, Ziegler SR, Adkinson NF.
NOTE: Can greatly reduce glycerin induced pain with small doses of lidocaine.
Injected glycerin produces pain that is proportional to total injected dose of glycerin,
Van Metre TE Jr, Rosenberg GL, Vaswani SK, Ziegler SR, Adkinson NF.
NOTE: Can greatly reduce glycerin induced pain with small doses of lidocaine.
Glycerol-induced hemoglobinuric acute renal failure in the rat. 1. Micropuncture study of the development of oliguria.
Rats-50%glycerol-10ml per kg of body weight
DONALD E.OKEN et. al.
To compare their amounts to used in rats to humans:Humans-70 kg=700 ml of 50% glycerolversus My maximum 1 ml of 50% glycerol
ProcalAmineProcalAmineProcalAmineProcalAmine
Given as IV hyperalimentation
infiltrates all the time up to 50 mls
contains 3% Glycerin Injection
No reported renal complications
(this is the work of Dean Reeves not me)f Dean Reeves not me)
Glycerol neurolysis: neurophysiological effects of topical glycerol application on rat saphenous nerve
• 25% glycerol-blocks C-fiber not A-fiber conduction
• 50-100% glycerol-blocks C and A fiber conduction
• Burchiel KJ, and Russell LC.
Glycerin is a mild Glycerin is a mild peripheral neurolyticperipheral neurolytic
Glycerin is a mild Glycerin is a mild peripheral neurolyticperipheral neurolytic
Causes subperineurial damage.
Journal Neuron-May 2013Journal Neuron-May 2013Journal Neuron-May 2013Journal Neuron-May 2013
Crippled mitrochondria in Schwann cells
Instead of synthesizing fatty acids broke them down
Build up of a acylcarnitine-a toxin
Interferes with neuron transmission
Result was peripheral neuropathy
Supports Liza’s pre-NPT theory that dextrose works as a food
Crippled mitrochondria in Schwann cells
Instead of synthesizing fatty acids broke them down
Build up of a acylcarnitine-a toxin
Interferes with neuron transmission
Result was peripheral neuropathy
Supports Liza’s pre-NPT theory that dextrose works as a food
Brachial Plexus Injection
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Brachial Plexus Injection
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N
LLLL
50 years before Dr. Halstead first brachial plexus block
Alexander Wood performed a brachial plexus block
Posterior brachial plexus techniquePosterior brachial plexus technique
Locate the SGN notch on the spine of the scapula
Can inject 1 inch deep or to bone
Inject 3-10 cc of of glycerin 3% solution
Can perform with our without ultrasound
3cc of Isovue Dye3cc of Isovue Dye
Suprascapular nerveRegion
Axillary Plexus Region
RetrogradeDye Flow
OmohyoidOmohyoidThe Omohyoid arises from the upper border of the scapula,
Attachment to the scapula varying from a few millimeters to 2.5 cm.
Young lady with back pain severe enough to place her in an extended care facility
Dextrose to cluneal nerves only lasted a few days
One session glycerin 3% to cluneal nerves produced almost complete pain relief for 3 months.
Cervical radiculopathy
Cervical radiculopathy
F
-Spinal Cord Stimulator not working-Failed all meds including gabapentin
-Was in agony-begging for help
Raynaud’s Phenomenon-Sympathetic
Blockade
Raynaud’s Phenomenon-Sympathetic
Blockade
Before and after and her photo
Before After
MEDICARE GUIDELINESMEDICARE GUIDELINESMEDICARE GUIDELINESMEDICARE GUIDELINES
Must follow two successful facet/medial branch local anesthesia injections
Must follow two successful facet/medial branch local anesthesia injections
Nerve destruction by glycerol, alcohol, phenol, iced saline, heat or cold )
For medial branch nerves
Medial Branch NeurotomiesMedial Branch NeurotomiesMedial Branch NeurotomiesMedial Branch Neurotomies
SI joint chemical SI joint chemical neurotomiesneurotomies
SI joint chemical SI joint chemical neurotomiesneurotomies
Medicare Guidelines(check with your Medicare contractor)Medicare Guidelines
(check with your Medicare contractor)
Peripheral nerve blocks involve the injection of chemical substances, such as local anesthetics, steroids, sclerosing agents and/or neurolytic agents into or near nerves to affect therapy for a pathological condition, such as
entrapment.Any billing of insurance or Medicare is the sole
responsibility of the attendee not the lecturer
Medicare GuidelinesMedicare Guidelines
No more than 3 injections per site in a 6 month period.
No more than 2 different sites at any one session.
NOVATIS SOLUTIONS, INC CMS CONTRACT CENTER
FOR MEDICARE AND MEDICAID SERVICES
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