Pancreatitis pain treatment: an overview.
Pain associated with chronic pancreatitis in particular is one of the most difficult and challenging syndromes that are presented to pain centers. Narcotic addiction is a common feature in this population. In this contribution an overview will be provided of the most pain treatment modalities based upon recent developments in the field of physiopathology, surgery, medical imaging and locoregional anesthetic techniques. Based upon personal experience it becomes progressively more clear that the most efficient alternative is not offered via neurolysis of the coeliac plexus. A shortlasting cure of 7-10 days with local anesthetics, injected via a coeliac plexus- or interpleural catheter may offer comparable but better reproducible durations of analgesia. Addition of corticosteroids during celiac plexus anesthesia may have additional benefits. Despite the progress in the field of internal medicine and surgery, a permanent solution is still far away for these patients.
Dept of Anesthesiology, University Hospital Antwerp, Edegem, Belgium.
M P
MP
Vercauteren
H
H
Coppejans
H A
HA
Adriaensen
D000208:Acute Disease; D000698:Analgesia / Q000379:methods*; D000765:Anesthesia, Conduction / Q000379:methods; D002447:Celiac Plexus; D002908:Chronic Disease; D006801:Humans; D009407:Nerve Block / Q000379:methods; D059408:Pain Management; D010179:Pancreas / Q000294:innervation; D010180:Pancreatectomy; D010195:Pancreatitis / Q000503:physiopathology*