title: Combined neurolytic block of celiac and superior hypogastric plexuses for incapacitating upper abdominal cancer pain.
abstract: OBJECTIVE
  To evaluate the efficacy of a combined neurolytic block of the celiac and superior hypogastric plexuses for incapacitating upper abdominal cancer pain.
  
  
  METHODS
  Fifty-two patients with advanced upper abdominal malignancies and incapacitating pain were equally randomized to receive a combined neurolytic block of the celiac and superior hypogastric plexuses (combined group) or a neurolytic celiac plexus block alone (NCPB group) using a 90% ethanol trans-intervertebral disk approach under CT guidance. Visual analogue scores (VAS), morphine consumption, and quality of life (QoL) were assessed before the procedure and 24 hrs, 1 week, 1 month, and 3 months after the procedure. The complications and side effects were also recorded.
  
  
  RESULTS
  The amount of ethanol used was 30 ± 5 ml in the combined group and 21 ± 3 ml in the NCPB group. VAS scores and morphine consumption decreased significantly pre- compared to post-procedure in both groups (p<0.05). QoL significantly improved 24 hrs, 1 week, and 1 month after the procedure compared with each group pre-procedure (p<0.05), but not after 3 months (p>0.05). The combined group had significantly lower VAS and morphine consumption than the NCPB group (p<0.05). QoL scores were significantly higher in the combined group 24 hrs, 1 week, and 1 month post-procedure than the NCPB group (p<0.05), but not after 3 months (p>0.05).
  
  
  CONCLUSIONS
  A combined neurolytic block of the celiac and superior hypogastric plexuses is more effective than neurolytic celiac plexus block alone in pain relief for patients with advanced upper abdominal cancer.
authors.affiliation: Department of Anesthesiology, Integrated Chinese and Western Medicine Hospital of Zhejiang Province, Hangzhou 310003, China.
authors.forename: Lixia
authors.initials: L
authors.lastname: Huang
authors.forename: Fan
authors.initials: F
authors.lastname: Tao
authors.forename: Zhen
authors.initials: Z
authors.lastname: Wang
authors.forename: Haifang
authors.initials: H
authors.lastname: Wan
authors.forename: Pisheng
authors.initials: P
authors.lastname: Qu
authors.forename: Hanguang
authors.initials: H
authors.lastname: Zheng
mesh_terms: D000008:Abdominal Neoplasms / Q000503:physiopathology* / Q000523:psychology; D002447:Celiac Plexus; D006801:Humans; D007001:Hypogastric Plexus; D009020:Morphine / Q000008:administration & dosage; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods*; D010148:Intractable Pain / Q000628:therapy*; D011788:Quality of Life; D014057:Tomography, X-Ray Computed; D064232:Visual Analog Scale
chemical_list: D009020:Morphine