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EUS-guided celiac plexus neurolysis and celiac plexus block

2003; Elsevier BV; Volume: 57; Issue: 7 Linguagem: Inglês

10.1016/s0016-5107(03)70036-4

1097-6779

Michael J. Levy, Maurits J. Wiersema,

Pharmacological Effects and Toxicity Studies

Pancreatic cancer and chronic pancreatitis commonly produce pain that is difficult to control. 1 Ventafridda GV Caraceni AT Sbanotto AM Barletta L De Conno F. Pain treatment in cancer of the pancreas. Eur J Surg Oncol. 1990; 16: 1-6 PubMed Google Scholar , 2 Lankisch PG. Natural course of chronic pancreatitis. Pancreatology. 2001; 1: 3-14 Abstract Full Text PDF PubMed Scopus (125) Google Scholar Initial therapy with nonsteroidal anti-inflammatory agents (NSAIDs) is often inadequate and necessitates opioid administration. Although opioids effectively relieve pain, they are associated with dry mouth, constipation, nausea, vomiting, drowsiness, delirium, and may impair immune function. 3 Ventafridda V Tamburini M Caraceni A De Conno F Naldi F. A validation study of the WHO method for cancer pain relief. Cancer. 1987; 59: 850-856 Crossref PubMed Scopus (615) Google Scholar , 4 Yeager MP Colacchio TA Yu CT Hildebrandt L Howell AL Weiss J et al. Morphine inhibits spontaneous and cytokine-enhanced natural killer cell cytotoxicity in volunteers. Anesthesiology. 1995; 83: 500-508 Crossref PubMed Scopus (257) Google Scholar In addition, patients with chronic pancreatitis risk narcotic dependence. Therefore, nonpharmacologic therapies, such as celiac plexus neurolysis (CPN), are often given with the goal of improving pain control and quality of life while reducing the risk of drug-related side effects.