Up to now, the studies in the world have demonstrated that CT-guided percutaneous neurolytic celiac plexus block (PNCPB) is an invaluable therapeutic modality in the treatment of refractory abdominal pain caused by cancer. Its efficacy of pain relief varied in reported studies. The main technical considerations which would affect the analgesic effects on abdominal pain included the patients' cooperation, needle entry approaches, combined use of blocking approaches, localization of the target area, dosage of the blocker, and so on. A success of PNCPB depends greatly on close cooperation with patients. The patient should be educated about the purpose and steps of the procedure, and trained of breathing in and breathing hold. The needle entry can be divided into the posterior approach and the anterior approach. The former one is the most commonly used in clinical practice, but the latter one is rarely used except in the cases that the posterior approach becomes technically difficult. Bilateral multiple blocking of celiac plexus and splanchnic nerves is often required to achieve optimal analgesia. The needle entry site, insertion course, and depth should be preselected and simulated on CT monitor prior to the procedure in order to ensure an accurate and safe celiac plexus block. The magnitude of analgesic effect is closely related to the degree of degeneration and necrosis of the celiac plexus. Maximally filling with blocker in the retropancreatic space is an indication of sufficient blocking. We also provided an overview of indications and contraindications, preoperative preparations, complications and its treatment of PNCPB.

Sophora viciifolia Hance is an edible plant used in traditional Chinese medicine. Sophocarpine, a tetracyclic quinolizidine alkaloid, is one of the most abundant active ingredients in Sophora viciifolia Hance. Here, we study the analgesic and anti-inflammatory effects, as well as the acute toxicity of sophocarpine from Sophora viciifolia Hance in mice. Sophocarpine (20, 40, and 80 mg/kgbw) significantly prolonged the delay period before a hot plate reaction occurred (all P < 0.05 ), and the delay before a tail-flick response was induced by a warm bath ( P < 0.05 ; P < 0.01 ). Sophocarpine (40, 80 mg/kg) resulted in dose-dependent inhibition of the writhing reaction induced by acetic acid in mice ( P < 0.05 ; P < 0.001 , respectively). Sophocarpine (80 mg/kg) reduced the total duration of a formalin-induced pain response ( P < 0.05 ). Sophocarpine prolonged the foot-licking latency of mice after the hot plate reaction, and this effect was antagonized by calcium chloride and enhanced by verapamil. Sophocarpine (20, 40, and 80 mg/kg) significantly inhibited xylene-induced ear edema ( P < 0.01 ; P < 0.001 ; P < 0.001 , respectively) and the penetration of acetic acid-induced dye into the peritoneal cavity ( P < 0.01 ; P < 0.01 ; P < 0.001 , respectively). It also reduced the levels of proinflammatory cytokine interleukin (IL)-1β, IL-6, and prostaglandin E2 ( P < 0.05 , P < 0.01 , P < 0.001 ) and those of serum nitric oxide ( P < 0.05 ). The results of this study suggest that sophocarpine possesses certain analgesic and anti-inflammatory activities, which may be related to calcium and inhibition of the secretion of inflammatory factors.