Every thing you wanted to know about glycerine

Every thing you wanted to know about glycerine* *But was afraid to ask

Dr. 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. La. Fargue-inoculation of morphine with the lancet. Bull. Acad. Med. Paris

MODERN GLYCERIN Injections

Reterogasserian 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

Sclerotherapy Treatment & Management For spider veins, glycerin was more effective than polidocanol. Samer Alaiti, MD, Other doctors use 1% glycerin with lidocaine

GLYCERIN CAUTIONS

Pain and dermal reaction caused by injected 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.

Glycerol-induced hemoglobinuric acute renal failure in the rat. 1. Micropuncture study of the development of oliguria. Rats-50%glycerol-10 ml 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% glycerol versus My maximum 1 ml of 50% glycerol

Procal. Amine 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)

GLYCERIN MECHANISMS OF ACTION

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 peripheral neurolytic s Causes subperineurial damage.

Journal 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

BRACHIAL PLEXUS INJECTIONS

50 years before Dr. Halstead first brachial plexus block Alexander Wood performed a brachial plexus block ``````

Posterior 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

3 cc of Isovue Dye Suprascapular nerve Region Axillary Plexus Region Retrograde Dye Flow

Omohyoid The Omohyoid arises from the upper border of the scapula, Attachment to the scapula varying from a few millimeters to 2. 5 cm.

GLYCERIN CASE HISTORIES

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 -Spinal Cord Stimulator not working -Failed all meds including gabapentin -Was in agony-begging for help

3 months after one injection-pain block

CRPS-Hands. Sympathetic blockade

Raynaud’s Phenomenon. Sympathetic Blockade Before After

Glycerol Neurolysis

MEDICARE GUIDELINES Nerve destruction by glycerol, alcohol, phenol, iced For medial branch nerves Must follow two successful facet/medial branch local anesthesia injections

Medial Branch Neurotomies

SI joint chemical neurotomies

(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 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

Peripheral nerve injections Pre-approval with: California’s Worker’s Compensation