title: Neurolytic celiac plexus block: a better alternative to opioid treatment in upper abdominal malignancies: an Indian experience.
abstract: 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 & 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.
authors.affiliation: Department of Anesthesiology, Critical Care and Pain, Tata Memorial Hospital, Parel, Mumbai, India. pnj5@hotmail.com
authors.forename: P N
authors.initials: PN
authors.lastname: Jain
authors.forename: S V
authors.initials: SV
authors.lastname: Shrikhande
authors.forename: Sheila N
authors.initials: SN
authors.lastname: Myatra
authors.forename: R
authors.initials: R
authors.lastname: Sareen
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002447:Celiac Plexus; D004067:Digestive System Neoplasms / Q000150:complications*; D005260:Female; D006801:Humans; D007194:India; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D009407:Nerve Block; D010148:Intractable Pain / Q000209:etiology / Q000628:therapy*; D011446:Prospective Studies; D011788:Quality of Life
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D009020:Morphine