Unilateral celiac plexus block

Two hundred patients with upper-abdominal malignancy were treated with oral morphine sulfate (OMS) during a 2-year period. Twenty-five of these patients experienced left-sided dragging pain and epigastric discomfort following a few months of adequate pain relief. An increase in the OMS did not relieve the pain. A unilateral left-sided neurolytic celiac plexus block with 20 mL of 50% alcohol was performed using a classical posterior percutaneous approach. This adjuvant technique yielded complete pain relief until death (15-75 days) in 22 patients. All of these patients continued to receive OMS without reduction in dose. Three patients required repeat block after 90 days. This experience documents the value of unilateral celiac plexus block as an adjuvant technique for the management of pain due to upper abdominal cancer.