Celiac Plexus Block in Cancer Pain Management

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著者

    • YAMAMURO MAKOTO
    • Department of Anesthesiology and Emergency Medicine, Tohoku University Postgraduate Medical School
    • KATO MASATO
    • Department of Anesthesiology and Emergency Medicine, Tohoku University Postgraduate Medical School
    • TAKAHASHI MASAHIKO
    • Department of Anesthesiology and Emergency Medicine, Tohoku University Postgraduate Medical School

抄録

The neurolytic celiac plexus block (NCPB) has been recommended for pain relief in patients with upper abdominal cancer by the WHO Cancer Pain Relief Program. In this article, we review the indications, techniques, and adverse effects of NCPB based on the previous findings in the literature and our own experience of 142 NCPBs during the past 11 years. No well-validated indication criteria for the NCPB have been available from invasive trials or non-invasive pain evaluations. Thus, the procedure has been employed using comprehensive pain assessment. Several modified approaches have been described for NCPB with differences in the target space where the alcohol is injected (precrural and retrocrural) and the insertion route of the needle (posterolateral and transdiscal). We have used the retrocrural transdiscal approach because of its simplicity and safety. The efficacy of the resultant pain relief does not differ among these techniques. Therefore, whether a distinction exists between blocks of the celiac plexus and those of the splanchnic nerves is controversial. The term "peri-aortic nerve block" may better describe the feature of this neurolytic intervention. The noteworthy adverse effects of alcoholic neurolysis include regional pain, hypotension, diarrhea, hypoxemia, and acute alcoholic intoxication. Most of them are transient and controllable. The diarrhea may counteract the morphine-induced constipation. NCPB relieves visceral pain in upper abdominal cancer with no serious adverse effects. We recommend this procedure to improve the quality of life of the patients suffering from abdominal cancer pain.

収録刊行物

  • THE TOHOKU JOURNAL OF EXPERIMENTAL MEDICINE

    THE TOHOKU JOURNAL OF EXPERIMENTAL MEDICINE 192(1), 1-18, 2000-09-01

    Tohoku University Medical Press

参考文献:  37件中 1-37件 を表示

被引用文献:  3件中 1-3件 を表示

各種コード

  • NII論文ID(NAID)
    10013015540
  • NII書誌ID(NCID)
    AA00863920
  • 本文言語コード
    ENG
  • 資料種別
    REV
  • ISSN
    00408727
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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