The Role of Neurolytic Celiac Plexus Block in the Treatment of Pancreatic Cancer Pain

Polati, Enrico; Luzzani, Aldo; Schweiger, Vittorio; Finco, Gabriele; Ischia, Stefano

doi:10.1016/j.transproceed.2008.03.115

Cited by 25 publications

(38 citation statements)

References 30 publications

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“…Ten percent of the CPB group required percutaneous splanchnicectomy at an average of 11‐month post‐CPB, whereas 12% of the control group required it significantly earlier after initiation of pain management by analgesics . All patients who received CPB in one study reported significantly reduced pain scores, whereas the majority of the CPB group required drug therapy also for complete relief in a different study …”

Section: Resultsmentioning

confidence: 97%

“…4,11 The correct position can be verified by an anesthetic test with two percent mepivacaine or with lidocaine followed by a diluted solution containing adrenaline. 12,13 Intraoperative CPB During surgery for pancreatic resection, neurolytic solutions are injected directly into the junction of splanchic nerves and the celiac ganglia to achieve chemical splanchnicectomy. 14 In some cases, laparoscopic procedures are used.…”

Section: Percutaneous Cpbmentioning

confidence: 99%

“…Group allocation was randomized in all included studies, 4,6,[11][12][13][14][15] but only one study properly concealed the treatment group from the participants. 4 Participant inclusion and exclusion criteria were well described in the text or tables.…”

Section: Assessment Of Biasmentioning

confidence: 99%

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Celiac Plexus Block for Treatment of Pain Associated with Pancreatic Cancer: A Meta‐Analysis

Zhong

Zeng

et al. 2013

Pain Practice

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Pancreatic ductal adenocarcinoma has a high rate of neural invasion (80 to 100%) and can be associated with moderate to severe pain in pancreatic cancer. Treatment of pain with celiac plexus blockage (CPB) combined with the three-step ladder utilization of pharmaceutical analgesics following WHO guidelines is used, but the evidence in randomized controlled trials is inconsistent. This meta-analysis identified and compared seven randomized control trials of pain relief from pancreatic cancer, by treatment with medical management alone to celiac plexus blockade with medical management. While no evidence of potential publication bias was detected, group size and statistical power may account for some of the inconsistent conclusions. The combined CPB groups had a significantly lower pain score at 4 weeks, but significance was not maintained at 8 weeks. The combined CPB groups required significantly less drug use compared to the combined control groups treated with pharmaceutical analgesics.

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Section: Resultsmentioning

confidence: 97%

Section: Percutaneous Cpbmentioning

confidence: 99%

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Celiac Plexus Block for Treatment of Pain Associated with Pancreatic Cancer: A Meta‐Analysis

Zhong

Zeng

et al. 2013

Pain Practice

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“…However, several studies focusing on pancreatic cancer or upper abdominal malignancies have provided information related to pNETS (de Oliveira, dos Reis, & Prado, 2004;Erdek, Halpert, Fernandez, & Cohen, 2010;Jain, Shrikhande, Myatra, & Sareen, 2005;Polati et al, 2008;Wong et al, 2004). However, several studies focusing on pancreatic cancer or upper abdominal malignancies have provided information related to pNETS (de Oliveira, dos Reis, & Prado, 2004;Erdek, Halpert, Fernandez, & Cohen, 2010;Jain, Shrikhande, Myatra, & Sareen, 2005;Polati et al, 2008;Wong et al, 2004).…”

Section: Literature Reviewmentioning

confidence: 99%

Celiac Plexus Block in Pancreatic Neuroendocrine Tumors

Morturano

Dunphy²

2011

Clinical Journal of Oncology Nursing

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Pancreatic neuroendocrine tumors (pNETs), an uncommon finding, are distinct from pancreatic carcinomas. When pNETs are unresectable and progressive, visceral pain often presents and is challenging to treat. Opioids commonly used for pain control are difficult to implement in this setting because of adverse side effects such as constipation. Neurolytic celiac plexus blocks are indicated in the treatment of visceral pain related to upper abdominal malignancies when opioid analgesia does not provide adequate relief or is contraindicated because of side effects. As a result, this article presents a brief review of pNETs, celiac plexus blocks, associated side effects, and contraindications along with related literature in the context of a case study.

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“…Patients should be taught the potential benefits of opioids and the expected side effects and their management; addiction, dependence, and tolerance should be explained. For Mr. D, the starting opioid dose at 40 mg oxycodone per day (a morphine equivalent dose of 60 mg day À1 ) was probably too high [15]. Dizziness and sedation, most likely due to the new opioid treatment, tend to improve spontaneously after 1-3 days with continued opioid exposure.…”

Section: Principles Of Medical Pain Managementmentioning

confidence: 99%