scholarly journals Celiac plexus neurolysis for the treatment of upper abdominal cancer pain

2013 ◽  
pp. 1209 ◽  
Author(s):  
Erich Fonoff ◽  
Neto ◽  
Angelos ◽  
San Martin ◽  
Monaco ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Celiac Plexus ◽  
Upper Abdominal

Alcohol Celiac Plexus Block for Upper Abdominal Cancer Pain

1979 ◽  
Vol 12 (4) ◽  
pp. 407
Author(s):  
Hung Kun Oh ◽  
Yang Sik Shin ◽  
Yong Aee Chun
Keyword(s):  
Cancer Pain ◽  
Celiac Plexus ◽  
Celiac Plexus Block ◽  
Upper Abdominal ◽  
Plexus Block

scholarly journals The Effectiveness of Alcohol Versus Phenol Based Splanchnic Nerve Neurolysis for the Treatment of Intra-Abdominal Cancer Pain

2016 ◽  
Vol 4;19 (4;5) ◽  
pp. 281-292 ◽  
Author(s):  
Dhanalakshmi Koyyalagunta
Keyword(s):  
Abdominal Pain ◽  
Cancer Pain ◽  
Visceral Pain ◽  
Splanchnic Nerve ◽  
Well Being ◽  
Pain Reduction ◽  
Celiac Plexus ◽  
Safe Procedure ◽  
Abdominal Organ ◽  
Upper Abdominal

Pancreatic and other upper abdominal organ malignancies can produce intense visceral pain syndromes that are frequently treated with splanchnic nerve neurolysis (SNN) or celiac plexus neurolysis (CPN). Although commonly performed with either alcohol or phenol, there is scant literature on the comparative effectiveness, duration of benefit, and complication profile comparing the 2 agents. This study presents a retrospective chart review of 93 patients who underwent SNN for cancer-related abdominal pain in order to describe patient characteristics, examine comparative efficacy, duration of benefit, and incidence of complications with alcohol vs. those of phenol. Consistent with previous studies, SNN reduced reported pain scores while not significantly reducing opioid consumption. No difference in pain outcomes was found comparing alcohol versus phenol based neurolytic techniques. Celiac axis tumor infiltration and pre-procedural local radiation therapy did not change the effectiveness of the procedure. Our data demonstrated that 44.57% of patients had ≥ 30% pain reduction while 43.54% did not have pain reduction. Interestingly, the procedure produced significant improvements in anxiety, depression, difficulty thinking clearly, and feeling of well-being. In addition, no difference in complications was seen between the agents either. SNN was an effective and relatively safe procedure for the treatment of pain associated with pancreatic and other upper abdominal organ malignancies in our sample of patients. Choice of neurolytic agent can appropriately be left to the clinical judgment and local availability of the treating physician. The change in ancillary symptoms has a theoretical basis that supports a biopsychosocial model of pain since changes in one target area (pain) impact other related ones (depression and anxiety). Key words: Celiac plexus, splanchnic nerves, neurolysis, nerve block, alcohol, ethanol, phenol, pain, cancer pain, abdominal pain, visceral pain, symptom assessment

Is celiac plexus block indicated for all upper abdominal cancer pain?

Pain ◽  
1990 ◽  
Vol 41 ◽  
pp. S91
Author(s):  
S. Jain ◽  
A. Kestenbaum ◽  
N. Shah ◽  
Y. Khan ◽  
L. Rubin
Keyword(s):  
Cancer Pain ◽  
Celiac Plexus ◽  
Celiac Plexus Block ◽  
Upper Abdominal ◽  
Plexus Block

Effectiveness of Percutaneous Celiac Plexus Ablation in the Treatment of Severe Cancer Pain in Upper Abdomen and Evaluation of Health Economics

2016 ◽  
Vol 34 (2) ◽  
pp. 142-147 ◽  
Author(s):  
Jun Cao ◽  
Yang He ◽  
Hongqiang Liu ◽  
Saibo Wang ◽  
Baocheng Zhao ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Treatment Group ◽  
Health Economics ◽  
Cancer Pain ◽  
Advanced Cancer ◽  
Celiac Plexus ◽  
Control Group ◽  
Celiac Plexus Block ◽  
Significant Difference ◽  
Upper Abdominal

Objective: To compare the effectiveness, adverse effects, and cost-effectiveness of percutaneous neurolytic celiac plexus block (NCPB) versus traditional medication strategies for the treatment of patients with advanced cancer having severe upper abdominal cancer pain. Methods: This retrospective study included 81 patients with advanced upper abdominal cancer admitted to The Sixth People’s Hospital Affiliated to Shanghai Jiaotong University between January 2013 and July 2014. The patients were divided into percutaneous NCPB (treatment) and medication for pain (control) groups. The outcomes were measured in terms of Numeric Rating Scale (NRS) score and Karnofsky Performance Status (KPS) score before treatment and on the 3rd, 7th, 14th, and 28th days posttreatment. The effectiveness and cost-effectiveness of the therapy were assessed using analysis of the health economics. Results: The improvements in NRS score (1.42 ± 1.09 vs 4.03 ± 0.96, P < .01) and KPS score (65.55 ± 9.09 vs 63.03 ± 8.961, P < .01) in the treatment group were significantly superior compared to the control group on the 7th day of treatment, followed by no significant difference between the 2 groups on the 14th and the 28th day of treatment. Health economics evaluation revealed that the medicine-specific costs and total health care costs were significantly reduced in the treatment group compared to the control group ( P < .05), but no significant differences between the 2 groups ( P > .05) were seen in the costs of hospitalization, examinations, and treatment. Conclusion: The percutaneous NCPB method shows promising results and better cost-effectiveness for treating patients with advanced cancer having severe upper abdominal pain.

scholarly journals Neuropathic Pain in Pancreatic Cancer: An Update of the Last Five Years

2021 ◽  
Vol 12 (3) ◽  
pp. 302-309
Author(s):  
Raffaele Pezzilli
Keyword(s):  
Pancreatic Cancer ◽  
Neuropathic Pain ◽  
Cancer Pain ◽  
Celiac Trunk ◽  
Celiac Plexus ◽  
Therapeutic Interventions ◽  
Ductal Adenocarcinoma ◽  
Negative Effect ◽  
The Central Nervous System ◽  
Upper Abdominal

Pain is the main symptom of pancreatic cancer (pancreatic ductal adenocarcinoma, PDAC). Pain in pancreatic cancer may be visceral, somatic or neuropathic in origin. Pain is produced by tissue damage, inflammation, ductal obstruction and infiltration. Visceral nociceptive signals caused by damage to the upper abdominal viscera are carried along sympathetic fibers, which travel to the celiac plexus nerves and ganglia, which are found at the T12-L2 vertebral levels, anterolateral to the aorta near the celiac trunk. From here, the signals are transmitted through the splanchnic nerves to the T5-T12 dorsal root ganglia and then on to the higher centers of the central nervous system. Somatic and neuropathic pain may arise from tumor extension into the surrounding peritoneum, retroperitoneum and bones and, in the latter case, into the nerves, such as the lumbosacral plexus. It should also be noted that other types of pain might arise because of therapeutic interventions, such as post-chemoradiation syndromes, which cause mucositis and enteritis. Management with non-steroidal anti-inflammatory agents and narcotics was the mainstay of therapy. In recent years, celiac plexus blocks and neurolysis, as well as intrathecal therapies have been used to control severe pain, at times resulting in a decreased need for drugs, avoiding their unwanted side effects. Pain may impair the patient’s quality of life, negatively affecting patient outcome and resulting in increased psychological stress. Even after recognizing the negative effect of cancer pain on patient overall health, studies have shown that cancer pain is still undertreated. This review focuses on neuropathic pain, which is difficult to handle; thus, the most recent literature was reviewed in order to diagnose neuropathic pain and its management.

A prospective study of EUS-guided celiac plexus neurolysis for pancreatic cancer pain

2001 ◽  
Vol 54 (3) ◽  
pp. 316-324 ◽  
Author(s):  
Naresh T. Gunaratnam ◽  
Aruna V. Sarma ◽  
Ian D. Norton ◽  
Maurits J. Wiersema
Keyword(s):  
Pancreatic Cancer ◽  
Cancer Pain ◽  
Prospective Study ◽  
Celiac Plexus ◽  
A Prospective Study
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