Celiac Plexus Nerve Block/Neurolysis

Abdominal pain is a common debilitating problem in patients with abdominal malignancy and often dramatically affects quality of life and survival. Management of cancer-related abdominal pain is a complex and challenging issue and often necessitates chronic use of high-dose narcotic analgesics, which can be associated with adverse effects.

An effective means of alleviating the intractable pain associated with abdominal malignancy is to disrupt nociceptive impulses at the level of the celiac plexus or splanchnic nerves. Image guided celiac plexus block and neurolysis are invaluable therapeutic options for managing refractory abdominal pain and are widely used.

Although the terms celiac plexus block and neurolysis are used interchangeably, they differ in terms of duration of action . Celiac plexus block refers to temporary disruption of pain transmission via the celiac plexus and is accomplished by injecting corticosteroids or long-acting local anesthetics. In contrast, celiac plexus neurolysis, or neurolytic celiac plexus block, refers to permanent destruction of the celiac plexus with ethanol or phenol.

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