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Endoscopic ultrasound-guided coeliac plexus block 

Endoscopic ultrasound-guided coeliac plexus block
Chapter:
Endoscopic ultrasound-guided coeliac plexus block
Author(s):

Arun Bhaskar

DOI:
10.1093/med/9780198834359.003.0064
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date: 04 August 2021

The landmark paper discussed in this chapter is ‘Endosonography-guided celiac plexus neurolysis’, published by Wiersema and Wiersema in 1996. Pain is one of its most distressing complaints of pancreatic cancer, affecting more than 80% of patients with advanced disease. However, the use of opioids and other drugs is often limited by undesirable side effects, which include somnolence, confusion, lethargy, and decreased cognitive function. Intrathecal drug delivery systems, although effective, are often deemed impractical in pancreatic cancer, due to its poor prognosis and the fact that it is often diagnosed late. Tumour infiltration of the coeliac plexus results in pain in the abdomen and back; thus, this area has often been targeted for analgesia via a neurolytic coeliac plexus block. The paper by Wiersema and Wiersema examines the efficacy of an approach that uses ultrasound to guide needle placement in celiac plexus neurolysis, in a study of 30 patients.

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