CT-GUIDED NEUROLYSIS FOR PAIN TREATMENT I N PATIENTS SUFFERING FROM TUMOR INFILTRATION OF THE CELIAC PLEXUS

To examine the efficiency of CT-guided celiac plexus block is applied for alleviation of pain in patients suffering from abdominal malignanc ies which cannot be managed adequately by drugs. Material and Methods: According to 35 CT-interventions pain intensity was retrospectively a nalysed in 20 patients (11 women, 9 men), who were referred for celiac plexus blockade. The mean age of the patients was 54 years, the mean observation period after blockade was 34 days. All patients underwent definitive neurolysis using 96% alcohol. Doses of oral given morphine sulfate before and three days after the intervention was evaluated as an objective parameter to describe pain intensity. Results were examin ed at a value of statistically significancy (p < 0.05) using t-test an d paired sign-test. Results: In 15/20 patients (75%) opioid doses were reduced after neurolysis. In 4 patients drug doses were constant and in one case opioid doses had to be increased shortly after CT-interven tion. The response according to pain intensity was statistically highl y significant (p=0.005). Mean doses of oral morphine sulfate in all pa tients was 524 mg/d (SD +/-: 606) (median: 300 mg/d), respectively 322 mg/d (SD +/- 404) (median: 150 mg/d) three days after the interventio n (p=0.001). All CT-interventions were well tolerated by the patients, without any complications. Conclusions: CT-guided celiac plexus block ade is a safe and effective technique in patients with tumor infiltrat ion and inadequate treated cancer pain using other analgesic means.