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

Alcohol block of the celiac plexus for control of upper abdominal pain caused by cancer and pancreatitis

1971 ◽  
Vol 34 (4) ◽  
pp. 575-579 ◽  
Author(s):  
Carlos Gorbitz ◽  
Milam E. Leavens
Keyword(s):  
Abdominal Pain ◽  
Visceral Pain ◽  
Celiac Plexus ◽  
Modified Technique ◽  
Content Type ◽  
Upper Abdominal ◽  
Fine Print

✓ A modified technique for alcohol block of the celiac plexus in cases of upper abdominal visceral pain is described. The hazards and complications of the procedure are discussed. The results in 11 patients are reported.

Celiac Plexus Blockade and Neurolysis: Fluoroscopy

2016 ◽  
Author(s):  
Imanuel R. Lerman ◽  
Joseph Hung ◽  
Dmitri Souzdalnitski ◽  
Bruce Vrooman ◽  
Mihir Kamdar
Keyword(s):  
Side Effect ◽  
Tumor Burden ◽  
Celiac Plexus ◽  
Safe Procedure ◽  
Side Effect Profile ◽  
Advantages And Disadvantages ◽  
Image Guided ◽  
Multiple Imaging ◽  
Upper Abdominal ◽  
Single Approach

Image-guided celiac plexus neurolysis can provide substantial and long-lasting pain relief in patients suffering from malignant pain from upper abdominal viscera. When performed by experienced hands, celiac plexus neurolysis also appears to be a relatively safe procedure with a limited side effect profile. Multiple imaging modalities are available for this procedure, though no single approach has systematically been proven superior in terms of efficacy or side effect profile. Each imaging guidance modality has advantages and disadvantages. Given the ability to visualize soft-tissue structures, CT guidance is recommended over fluoroscopy when intentionally transgressing into the retroperitoneum for celiac plexus neurolysis. It is also recommended in those patients with complicated anatomy, where anatomic distortion may complicate successful celiac blockade. However, in the patient without significant tumor burden involving the celiac axis and/or pancreatic body/tail, the fluoroscopy-guided retrocrural approach has been demonstrated to be efficacious, and complications are exceedingly rare.

Percutaneous retrocrural versus ultrasound-guided coeliac plexus neurolysis for refractory pancreatic cancer pain

2020 ◽  
pp. bmjspcare-2020-002246
Author(s):  
Yasushi Motoyama ◽  
Hitoaki Sato ◽  
Yuki Nomura ◽  
Norihiko Obata ◽  
Satoshi Mizobuchi
Keyword(s):  
Pancreatic Cancer ◽  
Abdominal Pain ◽  
Cancer Pain ◽  
Contrast Medium ◽  
Endoscopic Ultrasound ◽  
Ultrasound Guided ◽  
Coeliac Artery ◽  
Successful Case ◽  
Upper Abdominal ◽  
End Stage

We report a successful case of fluoroscopic percutaneous retrocrural coeliac plexus neurolysis (PRCPN) for pancreatic cancer pain refractory to endoscopic ultrasound-guided coeliac plexus neurolysis (EUS-CPN). A 55-year-old man with upper abdominal pain due to end-stage pancreatic cancer underwent EUS-CPN. Although CT revealed distribution of the contrast medium with neurolytic agent around the left and cephalic sides of the coeliac artery, the pain did not improve and became even more severe. PRCPN was performed, resulting in the drastic improvement of pain immediately. PRCPN should be considered when EUS-CPN is not effective.

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

scholarly journals Hemorrhagic Gastritis and Duodenitis Following Celiac Plexus Neurolysis

2009 ◽  
Vol 6;12 (6;12) ◽  
pp. 1001-1003
Author(s):  
Scott Pello
Keyword(s):  
Pancreatic Cancer ◽  
Abdominal Pain ◽  
Celiac Plexus ◽  
Celiac Plexus Block ◽  
Upper Endoscopy ◽  
Gi Bleeding ◽  
Upper Gi ◽  
History Of ◽  
Upper Abdominal ◽  
Plexus Block

Introduction: Neurolytic celiac plexus block is a well established intervention to palliate pain, and it potentially improves quality of life in patients suffering from an upper abdominal malignancy, specifically pancreatic cancer. Methods: We describe a 61-year-old female with a history of pancreatic cancer, unexplained transfusion dependent anemia with a normal recent upper endoscopy, and abdominal pain, who had previously undergone gastrojejunostomy and a Roux-en-Y hepaticojejunostomy as well as chemotherapy and radiation therapy. She suffered from intractable abdominal pain and elected to undergo palliative celiac plexus neurolysis. Results: The patient initially appeared to tolerate celiac plexus block well, however, 45 minutes after the procedure, the patient had bright red blood per rectum followed by bloody diarrhea. Her abdomen was soft and non-tender with minimal distention and positive bowel sounds. The patient’s hemoglobin decreased to 7.5 g/dl from 9.0 g/dl, and she received a blood transfusion. Upper endoscopy and enteroscopy demonstrated diffuse hemorrhagic gastritis and duodenitis. The bleeding was controlled and the patient remained hemodynamically stable. Ultimately, the patient did well and was discharged home. Discussion: We report a case of a patient with known history of gastritis and duodenitis, who developed severe upper GI bleeding immediately following the celiac plexus neurolysis. There are no published reports documenting similar cases. It is difficult to offer a precise physiologic explanation for this complication. However, we speculate that inhibition of sympathetic tone from the celiac plexus neurolysis caused increased blood flow to the GI system, and this resulted in active bleeding from previously indolent hemorrhagic gastritis and duodenitis. Conclusion: It may be beneficial for patients with a history of gastritis, duodenitis or GI bleeding to undergo a careful upper GI evaluation prior to celiac plexus neurolysis. Key words: Case report, pancreatic cancer, celiac plexus neurolysis, anemia, hemorrhagic gastritis and doudenitis, sympathetic block

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 CT-guided Celiac Plexus Neurolysis in the Management of Severe Upper Abdominal Pain

2020 ◽  
Vol 26 (2) ◽  
pp. 34-45
Author(s):  
Aleksey A. Eroshkin ◽  
Dmytro M. Romanukha
Keyword(s):  
Abdominal Pain ◽  
Celiac Plexus ◽  
Ct Guided ◽  
Upper Abdominal

Radiofrequency Thermocoagulation of Splanchnic Nerve in Patients with Upper Abdominal Pain

2004 ◽  
Vol 46 (1) ◽  
pp. 131
Author(s):  
Yong Ho Jang ◽  
Francis Sahngun Nahm ◽  
Bo Kyung Kim ◽  
Jae Sang Sung ◽  
Yong Chul Kim ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Splanchnic Nerve ◽  
Radiofrequency Thermocoagulation ◽  
Upper Abdominal
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