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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. 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.

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

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

  2. 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. LaFargue-inoculation of morphine with the lancet. Bull. Acad. Med. Paris

  3. MODERN GLYCERIN Injections

  4. 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 Sainiet al

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

  6. GLYCERIN CAUTIONS

  7. 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.

  8. 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% glycerol versus My maximum 1 ml of 50% glycerol

  9. ProcalAmine • 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)

  10. GLYCERIN MECHANISMS OF ACTION

  11. 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.

  12. Glycerin is a mild peripheral neurolytic • Causes subperineurial damage.

  13. 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

  14. BRACHIAL PLEXUS INJECTIONS

  15. Brachial Plexus Injection ``````````` 50 years before Dr. Halstead first brachial plexus block Alexander Wood performed a brachial plexus block • N • LLLL

  16. 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 • Can perform with our without ultrasound

  17. 3cc of Isovue Dye Suprascapular nerve Region Axillary Plexus Region Retrograde Dye Flow

  18. Omohyoid • The Omohyoid arises from the upper border of the scapula, • Attachment to the scapula varying from a few millimeters to 2.5 cm.

  19. GLYCERIN CASE HISTORIES

  20. 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.

  21. Cervical radiculopathy • F -Spinal Cord Stimulator not working -Failed all meds including gabapentin -Was in agony-begging for help

  22. 3 months after one injection-pain block

  23. CRPS-Hands-Sympathetic blockade

  24. Raynaud’s Phenomenon-Sympathetic Blockade • Before and after and her photo After Before

  25. Glycerol Neurolysis

  26. MEDICARE GUIDELINES • Must follow two successful facet/medial branch local anesthesia injections • For medial branch nerves • Nerve destruction by glycerol, alcohol, phenol, iced saline, heat or cold )

  27. Medial Branch Neurotomies

  28. SI joint chemical neurotomies

  29. 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

  30. 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

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

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