[Ganglion block. Celiac plexus neurolysis].

Area of Science:

• Interventional Radiology
• Pain Management
• Gastroenterology

Background:

• Upper abdominal pain, often from pancreatic cancer or inflammatory conditions, presents significant treatment challenges.
• Celiac plexus neurolysis using computed tomography (CT) guidance is a primary method for targeting upper abdominal pain.
• Ethanol injection destroys nociceptive fibers, offering pain relief for visceral pain.

Purpose of the Study:

• To evaluate the efficacy and safety of CT-guided celiac plexus neurolysis for managing upper abdominal pain.
• To assess the procedure's effectiveness in patients with malignant and inflammatory conditions.
• To determine the need for repeat interventions in cases of temporary pain relief.

Main Methods:

• CT-guided neurolysis involves needle insertion into the antecrural space via anterior or posterior approaches.
• A volume of 20-50 ml of ethanol, mixed with local anesthetic and contrast, is injected.
• The procedure targets the celiac plexus to ablate pain-transmitting nerve fibers.

Main Results:

• CT-guided celiac plexus neurolysis provided pain reduction or decreased analgesic needs in up to 80% of patients with upper abdominal tumors.
• Pain relief could be temporary, sometimes necessitating a repeat procedure.
• The efficacy in inflammatory conditions was generally less pronounced compared to oncological cases.

Conclusions:

• CT-guided celiac plexus neurolysis is a safe and effective treatment for diminishing upper abdominal pain, especially in cancer patients.
• The procedure can be safely repeated if initial pain relief is not sustained.
• This interventional technique offers a valuable option for difficult-to-treat visceral pain.