Neurolytic Celiac Plexus Block: A Better Alternative to Opioid Treatment in Upper Abdominal Malignancies: An Indian Experience

The majority of patients with advanced upper abdominal malignancies suffer from moderate to severe pain due to unavailability of morphine in developing world. This study was undertaken to evaluate the role of neurolytic celiac plexus block on pain and quality of life in this patient subpopulation. O...

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Bibliographic Details
Published in:Journal of pain & palliative care pharmacotherapy 2005-01, Vol.19 (3), p.15-20
Main Authors: Jain, P. N., Shrikhande, S. V., Myatra, Sheila N., Sareen, R.
Format: Article
Language:English
Subjects:
Adult
Aged
Analgesics, Opioid - therapeutic use
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
cancer pain
Celiac Plexus
Digestive System Neoplasms - complications
Female
Humans
India
Karnofsky Performance Status
Male
Middle Aged
Morphine - therapeutic use
Nerve Block
Neurolytic celiac plexus block
opioid consumption
Pain, Intractable - etiology
Pain, Intractable - therapy
Prospective Studies
Quality of Life
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Summary:The majority of patients with advanced upper abdominal malignancies suffer from moderate to severe pain due to unavailability of morphine in developing world. This study was undertaken to evaluate the role of neurolytic celiac plexus block on pain and quality of life in this patient subpopulation. One hundred consecutive patients receiving opioids for their pain relief were divided in two groups. Group I (control) patients received oral morphine and NSAIDs and group II (study) patients underwent neurolytic celiac plexus block (NCPB) to compare their effects on pain relief, morphine consumption, quality of life (QOL), Karnofsky and performance scores up to one month. NCPB provided statistically significant better pain relief and reduced morphine consumption at one month (P = 0.000). Superior Karnofsky and performance scores also favored NCPB group (P = 0.000); however the difference in overall QOL was not statistically significant (P = 0.24). Patients in oral morphine group had more side effects (94% vs. 58%) as compared to NCPB (P = 0.000). NCPB is an effective tool to reduce opioid requirement and the drug-related adverse effects. It is a rewarding technique, especially when morphine availability and its easy accessibility to the deserving patient is poor.
ISSN:1536-0288
1536-0539
DOI:10.1080/J354v19n03_04