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Unilateral celiac plexus block

A Prasanna1

  • 1Multidisciplinary Centre for Pain Relief and Palliative Care, Kasturba Hospital, Manipal, India.

Journal of Pain and Symptom Management
|March 1, 1996
PubMed
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For upper abdominal cancer pain refractory to oral morphine sulfate (OMS), a unilateral neurolytic celiac plexus block provided effective pain relief. This intervention allowed continued OMS use without dose increase in most patients.

Area of Science:

  • Oncology
  • Pain Management
  • Interventional Radiology

Background:

  • Oral morphine sulfate (OMS) is a common analgesic for cancer pain.
  • Some patients develop refractory pain despite adequate OMS dosage.
  • Upper abdominal malignancies can cause complex pain syndromes.

Purpose of the Study:

  • To evaluate the efficacy of unilateral neurolytic celiac plexus block as an adjuvant therapy for refractory upper abdominal cancer pain.
  • To assess the impact of this intervention on oral morphine sulfate requirements.

Main Methods:

  • A cohort of 200 patients with upper-abdominal malignancy treated with OMS was retrospectively analyzed.
  • Twenty-five patients experiencing refractory pain underwent a unilateral left-sided neurolytic celiac plexus block using 50% alcohol via a posterior percutaneous approach.

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  • Pain relief and OMS dosage were monitored post-procedure.

    • Main Results:

    • Twenty-two of 25 patients (88%) achieved complete pain relief until death (15-75 days) following the celiac plexus block.
    • All patients who experienced pain relief continued OMS without dose escalation.
    • Three patients required a repeat block after 90 days.

    Conclusions:

    • Unilateral neurolytic celiac plexus block is a valuable adjuvant technique for managing refractory pain in upper abdominal cancer.
    • This interventional approach can enhance pain control without increasing opioid dosage.
    • Celiac plexus block offers sustained relief in a significant proportion of patients with advanced malignancy.