Abstract
Chronic visceral abdominal pain due to malignant and inflammatory conditions can be
challenging to treat, requiring a multidisciplinary approach. Opiates are commonly
employed in the palliation of chronic abdominal pain but are complicated by quality
of life-limiting side effects such as nausea, vomiting, sedation, and constipation.
Celiac plexus block and neurolysis (CPBN) are important tools in the multimodality
approach to such pain, with documented improvement in pain scores and, importantly,
reduction in opiate demands and improvement in quality of life. It targets the celiac
relay station that mediates transmission of visceral nociceptive information from
upper abdominal organs; distinguishing from somatic and neuropathic pain is important
for clinical success. Key determinants of procedure success include patient selection,
understanding relevant anatomy, how that anatomy is distorted by pathology, selection
of location for block or neurolysis, as well as distribution and volume administered
of injectate during the procedure. CPBN is a safe procedure associated with a low
complication rate and may demonstrate better efficacy when used earlier in a patient's
disease course.
Keywords
celiac plexus neurolysis - celiac plexus block - cancer pain management
