Celiac Plexus Block and Neurolysis: A Review.

Area of Science:

• Gastroenterology and Pain Management

Background:

• Chronic pancreatitis and pancreatic cancer frequently cause severe pain.
• Opioid therapy is a common pain management strategy but often presents challenges.
• Alternative interventions are needed for refractory pain in these conditions.

Purpose of the Study:

• To evaluate the safety and efficacy of endoscopic ultrasound-guided celiac plexus interventions for pain management.
• To compare celiac plexus block and neurolysis as treatment modalities.

Main Methods:

• Endoscopic ultrasound (EUS)-guided celiac plexus block using local anesthetic for transient pain interruption.
• EUS-guided celiac plexus neurolysis employing chemical ablation for prolonged pain relief.
• Procedures performed in unilateral or bilateral positions depending on the technique.

Main Results:

• Celiac plexus block and neurolysis are demonstrated as safe and effective pain alleviation techniques.
• These EUS-guided procedures provide viable alternatives to opioid therapy.
• Different positional approaches (unilateral/bilateral) are utilized for block and neurolysis.

Conclusions:

• EUS-guided celiac plexus block and neurolysis are effective and safe options for managing pain associated with chronic pancreatitis and pancreatic cancer.
• These interventions offer a valuable alternative to challenging opioid treatments.
• The choice between block and neurolysis, and their positional application, allows for tailored pain management strategies.