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Neurolytic Celiac Plexus Blocks for Cancer
What are Neurolytic Celiac Plexus Blocks for Cancer?
Pain can be an accompanying clinical feature of some forms of cancer. In this article, we take a look at a specialist treatment option called neurolytic celiac plexus block for cancer related pain. This procedure is performed by trained professionals such as radiologists and anesthesiologists. It can also be performed by surgeons.
Who needs Neurolytic Celiac Plexus Blocks for Cancer?
Pain is transmitted through different nerve fibers. In cancer of an organ, nerve fibers that supply the organ can be involved or irritated, causing a great degree of pain. As a first line of treatment, some painkillers may be offered that can help. However, sometimes these painkillers may not be sufficient to ease pain, instead requiring specialist treatments such as neurolytic celiac plexus block. This procedure blocks the nerve fibers that transmit the pain impulses, thus reducing the pain that accompanies the cancer.
Neurolytic celiac plexus block is used in managing pain in patients suffering from cancer of the pancreas. The celiac plexus is a group of nerves that supply various organs in the abdomen.
What are the steps in Neurolytic Celiac Plexus Blocks for Cancer?
The procedure is performed using either an endoscopic ultrasound approach or a Percutaneous approach. In an endoscopic ultrasound approach, the procedure is performed using an ultrasound probe attached to an endoscope. In a percutaneous approach, the procedure is performed through the skin.
Locating Your Celiac Plexus
In an Endoscopic Ultrasound Approach, a tube, called an endoscope, with an ultrasound probe attached to the end of it is passed into the stomach. The ultrasound waves are transmitted through the stomach allowing clear visualization of the pancreas. Once the pancreas is located, the celiac plexus is found in close proximity.
If your doctor is using a Percutaneous Approach, the procedure is usually performed by an anesthesiologist. You are positioned face down, and the procedure is performed through your back. The back is cleaned with an antiseptic solution, and a dye is injected through a vein to highlight the area where the celiac plexus is located. The location is determined using a CT scan machine.
Performing the Injection
Once the celiac plexus is located, a needle is passed into the nerve fibers. An anesthetic agent followed by a neurolytic, or nerve killing, agent is injected into the celiac plexus. The anesthetic agent numbs the area that is supplied by the nerves, but the effects are usually short lived. On the other hand, the neurolytic agents kill the nerve fibers and blocks the transmission of nerve impulses through them, thus blocking further pain. The most commonly used neurolytic agents are alcohol and steroids.
Following the procedure, a close eye is kept on the patient to make sure they feel well. While the anesthetic agent numbs the pain immediately, the neurolytic agent can take a few days to kick in. Effects can last up to 6 to 9 months, so repeat procedures may be required in the future.
What are the side effects of neurolytic celiac plexus block?
Some of the common side effects include:
- Low blood pressure
- Pain at the site of the injection, along with muscle spasms
- Allergic reaction to the drugs can occur
There are rarer side effects such as injury to the surrounding structures and organs. On rare occasions, the neurolytic agent may get injected into the blood stream, which can cause seizures. This is why the procedure is only performed by experts.