Invasive interventions are primarily reserved for patients who are unable to achieve a satisfactory balance between analgesia and side effects of systemic analgesic therapies. A lower dose of opioid, which can provide the same analgesic effect, can be delivered through invasive routes. Primary invasive interventions include central nervous system techniques and Peripheral techniques.

Central Nervous System Techniques

Spinal opioid infusions may be combined with local anesthesia. Administration is by way of an epidural or subarachnoid infusion.

Local Anesthetic Blocks

• Celiac Plexus Block
• Lumbar Sympathetic Block
• Stellate Ganglion Block
• Chemical Rhizotomy
• Trigeminal Neurolysis
• Transacral Neurolysis

Nerve Blocks

A local anesthetic block with a local anesthetic agent lasts a few hours. A neurolytic block with a destructive agent such as alcohol or phenol last for weeks to months.