Indications for celiac plexus block (A) pancreatic cancer
No indications for surgery of pancreatic cancer and abdominal pain patients require anesthetic is the best indication of CPN. CPN is to handle the largest number of cases of pancreatic cancer. Unfortunately, pancreatic disease, pain mechanisms are not yet fully understood, the theory has long been controversial issues. Potential partners could include expansion of membrane obstruction, inflammation, pancreatic interstitial pressure increase, ischemia, direct neural invasion, tumor expansion and lymph nodes. Pancreatic enzyme secretion nerve tumor can spread along the nerve, causes inflammation around the tumor more sensitive to nerve stimulation, induced pain. Pancreatic cancer often present outside the nerve membrane invasion. 34 cases of pancreatic cancer, 34 cases had nerve plexus invasion film, the T and tumor grade. Increased sensitivity to the spinal cord can cause a large number of neurotransmitter release, anger increased the sensitivity of neurons in the spinal cord. Although the oral pain medication as the first line treatment, even if the full dose of the narcotic analgesics will fail, and the side effects will reduce the quality of life. Can not be surgically removed for cancer patients, other pain methods include radiation therapy, surgical removal of visceral nerve, surgical approach CPN, non-surgical path CPN.
Indications for celiac plexus block (b) chronic pancreatitis
Pain in chronic pancreatitis, CPB case selection criteria are still not very clear. Intractable abdominal pain who required large doses of anesthetics can be used as an appropriate candidate for CPB cases. CPB to control pain in chronic pancreatitis still need to do a lot of random double-blind controlled study to determine the hormonal or neural solvent effect.
Indications for celiac plexus block (c) the indication of non-pancreatic diseases
In most cases, CPN is mainly used for treatment of pancreatic diseases, in recent years have increasingly used this method to treatment of other diseases were reported. At present, the technology has been used for treatment of a variety of malignant lesions, including the stomach, esophagus, colon, lung, liver, biliary system, kidney, breast, abdominal sarcoma and other malignant diseases. CPB also successfully used for benign diseases, including chronic pain treatment. One study even paralysis of the stomach neurosurgical patients injected with bupivacaine, the success of a celiac plexus block. Speculated that it might block the sexual sense of the central regulatory mechanism of gastric motility. There are reports of recent blood Yin Lin, intermittent pain in patients treated with EUS-CPB reported by the good effect.