The use of coeliac plexus blockade in patients with chronic pain

Abstract

Over a four-year period from October 1984 to September 1988, a total of 101 coeliac plexus blocks were performed in this unit. Of these, 89 were in patients suffering intractable abdominal pain due to cancer, and 12 were in patients with pain secondary to benign disease processes. All were performed using X-ray screening and with intravenous sedation rather than general anaesthesia. Excellent or good pain relief was obtained in 80% of the patients with malignant disease, whilst 50% of patients with benign disease had good or complete relief of pain. The only serious complication encountered was a case of paraplegia - probably due to spinal cord ischaemia secondary to damage of the artery of Adamkiewicz.

Current Indications of Neurolytic Blocks in Cancer Pain

“…A recent metaanalysis of the literature has revealed the inconsistencies in the features and completeness of the data reported [18]. However, pain relief is remarkable in both the shortand long-term, although often inadequately characterized [32,33]. Short-term success has been reported in 89% of about 1000 patients included in the meta-analysis [18].…”

Opioid-responsive and opioid-non-responsive pain in cancer

“…The first reports retrospectively on extensive experience over a 4-year period in 101 patients: good pain relief was obtained in 80% of the patients with malignant disease (not all had carcinoma of the pancreas). 39 However, a review of the literature on coeliac plexus block published over the last 25 years points out that the duration of analgesia, long-term morbidity and relative analgesic efficacy of coeliac plexus block are difficult to definitively categorise from the published papers and the authors question its usefulness. 40 However they also point out that in experienced hands it is a safe procedure.…”