Cancer Pain – Celiac Plexus Block

Advanced, Clinical Subspecialties

Indications : Treatment of visceral abdominal pain (T5-T12) derived from sympathetic afferent nerves, often associated with abdominal cancers, especially pancreatic cancer. Occasionally to treat chronic pancreatitis.

How To Perform : Celiac plexus located at L1 on the anterolateral surface of the Aorta. Using fluoroscopy, typically performed with posterior entry point just below the level of the 12th rib.

Side Effects : Orthostatic Hypotension (most common), Diarrhea (2nd most common), Spinal/Epidural Injection, LAST, Perforation of Nearby Structures (Aortic/IVC/Visceral Organs), Retroperitoneal Hemorrhage, Pneumothorax, Chylothorax, Paraplegia

Sources

    Burton, AW, Phan, et al. Treatment of cancer pain: Role of neural blockade and neuromodulation. In: Cousins and Bridenbaugh's Neural Blockade in Clinical Anesthesia and Pain Medicine, 4th, Lippincott, Williams & Wilkins, 2009. P.1122.

    Cornman-Homonoff J, Holzwanger DJ, Lee KS, Madoff DC, Li D. Celiac Plexus Block and Neurolysis in the Management of Chronic Upper Abdominal Pain. Semin Intervent Radiol. 2017 Dec;34(4):376-386

    See also Cancer Pain – Plexus Block

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Answered correctly

2021

Year asked

Author
Samuel MacCormick, MBBCh