Presented at the 2012 AAPM Annual Meeting « Back

Assessment of Continuous Celiac Plexus Block (CCPB) Outcomes and Technique in the Management of Refractory Visceral Cancer Pain

Feng Rui Yang, MD, comfort668@yahoo.com.cn, Capital Medical University of China—Bei Jing, Bei Jing, China

Objective: To assess outcomes and safety of continuous celiac plexus block (CCPB). Materials and Methods: Twelve patients with terminal visceral (mostly pancreatic) cancer who failed conservative measures were managed by continuous celiac plexus block guided by computed tomography at the pain department of Xuanwu Hospital from January 2005 to June 2010. The study evaluated continuous celiac plexus block efficacy with regard to pain relief, its adverse effects/complications. Results: Continuous celiac plexus block efficacy with regard to pain relief was exhibited by a marked decrease in the visual analog score and in opioid consumption, with preprocedural mean values dropping from (8.7±1.0) and (155±56) mg/d of morphine to (1.8± 1.1) and (0) mg/d at the first postprocedural visit, respectively. These results persisted during the 6-month follow-up period or until death. Minor adverse effects (moderate diarrhea and mild hypotension) were frequent (n = 3, and n = 4, respectively), and severe complications occurred in one patient with a transient paraparesis (n = 1). No procedure-related mortality was observed. Conclusions: Continuous celiac plexus block is a technique that provides analgesia and the alleviation of the secondary undesirable effects of analgesic drugs resulting from the decrease of morphine consumption in patients with upper abdominal malignancies. In experienced teams, the reliability of its analgesic effect is high, with a low rate of severe complications.

Funding: None