What is the evidence for EUS-guided celiac plexus block/neurolysis?

EUS-guided celiac ganglion irradiation with iodine-125 seeds for pain control in pancreatic carcinoma: a prospective pilot study

“…Table 3 shows the VAS score and MS Contin controlledrelease tablet (Mundipharma Pharmaceutical Co, Ltd, Beijing, People's Republic of China) consumption before and after seed implantation. Before treatment, the mean VAS score was 5.78 (range [4][5][6][7][8], and all patients received MS Contin; the mean consumption of this drug was 68.26 mg (range 40-90 mg). Immediately after the procedure, no patient reported pain relief.…”

“…Although CPN is considered safe, it provides limited benefit in terms of degree and duration of pain relief; the greater the extent of invasion of the celiac ganglia is, the less the analgesic effect achieved by CPN is. [2][3][4][5] Such limited efficacy may be at least partially attributed, until recently, to the lack of an imaging technique for the celiac ganglia, affecting the accuracy of the neurolytic agent delivery. The recognition that the celiac ganglia can be visualized and accessed by EUS allows the direct injection of neurolytic agents into individual celiac ganglia.…”

The role of endoscopy in the evaluation and management of patients with solid pancreatic neoplasia

“…CPN is the preferred therapy in patients with cancerrelated pain. 73 A meta-analysis by Kaufman et al 74 of 5 studies including 199 patients found that EUS-CPN was effective in alleviating abdominal pain in 72% of patients. A double-blind, controlled trial found that early EUS-CPN reduces pain and may moderate morphine consumption in patients with newly diagnosed, painful, inoperable pancreatic cancer.…”