Ultrasound-guided celiac plexus neurolysis in advanced upper abdominal cancer pain

Abstract

Most of cancer patients experience severe, uncontrollable pain during the course of their disease, and the management of this pain is a primary challenge for the cancer patient and the treating physician. Celiac plexus neurolysis (CPN) is a method for relief of pain caused by neoplasms in the upper part of the abdomen. Also, it reduces daily analgesic requirements. Methods to administer neurolytic agents to the celiac plexus include fluoroscopy, CT imaging, percutaneous ultrasound, endoscopic ultrasound, or surgery. Ultrasound-guided technique enables us to secure an accurate needle position and to monitor the distribution of the local anesthetic in real time which improve the quality and decrease the complications 20 adult patients suffering from abdominal pain due to upper abdominal cancer underwent ultrasound-guided CPN with injection of 15-30 ml of 50% sterile alcohol on the side of the celiac trunk after successful diagnostic block. We used visual analog scale (VAS) score to assess the degree of pain relief immediately after injection, 1 week, 1 month and 3 months post-neurolysis. Also, analgesic requirements and complications were documented.