Dawood Aghamohammadi - Professor of Anesthesiology, Tabriz University of Medical Science, ImamReza Medical, Research & Training Hospital, Tabriz, Iran

A great number of patients with cancer pain do not obtain satisfactory pain relief with conventional first-lineapproaches, including treatment of underlying causes, if possible, opioid-based pharmacotherapy.Different types of pain or pain syndromes are present in all phases of cancer (early and metastatic) and areinadequately treated in ۵۶% to ۸۲.۳% of patients.Chemical neurolysis (Wallerian degeneration), radiofrequency neurotomy, and cordotomy and some surgicalapproaches are mainstays in the treatment of cancer pain. Ozonolysis refers to the organic chemical reactionwhere ozone is employed to cleave the unsaturated bonds of alkenes, alkynes. A thorough knowledge ofneural anatomy and pain transmission pathways is fundamental to appropriate patient and technique selection.Imaging guidance and strict asepsis are prerequisites.During chemical neurolysis nerve damage is achieved by means of Neurodestructive interventions like thesecan help provide durable and effective pain relief with fewer systemic side effects as compared topharmacologic therapies.obtaining a thorough history, physical exam, and complete diagnostic laboratory workup, a recent radiologicalevaluation is often necessary to identify the cause of the pain and to prevent complications associated with theinterventional technique. A psychological assessment is frequently performed to determine if the patient issuitable for intervention, . However, for patients with pain intractable to conservative treatment modalities,these neurodestructive options can be considered for symptom palliation.