Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jun;12(3):825-840.
doi: 10.1007/s40122-023-00506-0. Epub 2023 Apr 13.

Long-Term Analgesic Efficacy of Neurolytic Splanchnic Nerve Block via the Transintervertebral Disc Approach to Retrocrural Space: A Multicenter Retrospective Study

Ryota Yanaizumi  1 , Yusuke Nagamine  2 , Shinsuke Harada  3 , Tomoko Kuramochi  4 , Shuhei Ota  5 , Yoichiro Abe  6 , Masayuki Nakagawa  6 , Kenya Kamijima  6 , Maya Hayashi  6 , Toshiharu Tazawa  7 , Kenichi Ogawa  8 , Takahisa Goto  9
Affiliations

Long-Term Analgesic Efficacy of Neurolytic Splanchnic Nerve Block via the Transintervertebral Disc Approach to Retrocrural Space: A Multicenter Retrospective Study

Ryota Yanaizumi et al. Pain Ther. 2023 Jun.

Abstract

Introduction: The celiac plexus block is effective for treating intractable cancer pain and has been the focus of many studies. At our affiliated institution, fluoroscopy-guided splanchnic nerve block with a single needle via the transintervertebral disc approach was the first choice of treatment. The short-term efficacy of this technique has been reported, but the long-term efficacy is not clear. In the present study, we investigated the long-term analgesic efficacy of this technique.

Methods: This multicenter, retrospective, observational study reviewed the medical records of patients who underwent neurolytic splanchnic nerve block (NSNB) via the transintervertebral disc approach for intractable cancer pain at five tertiary hospitals in Japan from April 2005 to October 2020. The primary outcome was the long-term analgesic efficacy of a one-time NSNB via the transintervertebral disc approach.

Results: In total, 76 patients were included in the analysis. The median lowest numerical rating scale (NRS) score was 1 within 14 days. At 1, 2, 3, and 6 months after the nerve block, the median NRS score was also ≤ 2, while the median equivalent oral morphine dose did not show any clinically noticeable increase at those times.

Conclusion: The long-term analgesic efficacy of NSNB via the transintervertebral disc approach in patients with intractable cancer pain has been demonstrated.

Keywords: Cancer pain; Celiac plexus; Interventional; Intervertebral disc; Nerve block; Radiology; Splanchnic nerves.

Plain language summary

The celiac plexus block is effective for treating intractable cancer pain and has been the focus of many studies. The celiac plexus nerve block relieves intractable cancer pain arising from the pancreas or other organs in close proximity, and the splanchnic nerve block is considered clinically equivalent to the celiac plexus block for analgesia. At our affiliated institution, fluoroscopy-guided neurolytic splanchnic nerve block with a single needle via the transintervertebral disc approach is the first choice of treatment because it is technically simpler and less invasive than other approaches. While the short-term efficacy of this technique is known, its long-term efficacy remains unclear. Thus, this multicenter, retrospective, observational study aimed to investigate the long-term analgesic efficacy of a neurolytic splanchnic nerve block via the transintervertebral disc approach. The medical records of patients in whom intractable cancer pain was managed using this technique at five tertiary hospitals in Japan were analyzed. The primary outcome was the long-term analgesic efficacy of a one-time neurolytic splanchnic nerve block via the transintervertebral disc approach. The median lowest numerical rating scale score was 1 within 14 days. At 1, 2, 3, and 6 months after the nerve block, the median numerical rating scale score was also ≤ 2, while the median equivalent oral morphine dose did not show any clinically noticeable increase at those times. This technique may reduce opioid dose and associated side effects compared with long-term conventional pharmacotherapy alone.

PubMed Disclaimer

Conflict of interest statement

Ryota Yanaizumi, Yusuke Nagamine, Shinsuke Harada, Tomoko Kuramochi, Shuhei Ota, Yoichiro Abe, Masayuki Nakagawa, Kenya Kamijima, Maya Hayashi, Toshiharu Tazawa, Kenichi Ogawa, and Takahisa Goto declare that they have nothing to disclose.

Figures

Fig. 1
Fig. 1
Flow chart of the study. NSNB, neurolytic splanchnic nerve block; NRS, numerical rating scale
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Raj P. Celiac plexus/splanchnic nerve blocks. Tech Reg Anesth Pain Manag. 2001;5:102–115. doi: 10.1053/trap.2001.24272. - DOI
    1. Ina H, Kitoh T, Kobayashi M, Imai S, Ofusa Y, Goto H. New technique for the neurolytic celiac plexus block: the transintervertebral disc approach. Anesthesiology. 1996;85:212–217. doi: 10.1097/00000542-199607000-00028. - DOI - PubMed
    1. Yamamuro M, Kusaka K, Kato M, Takahashi M. Celiac plexus block in cancer pain management. Tohoku J Exp Med. 2000;192:1–18. doi: 10.1620/tjem.192.1. - DOI - PubMed
    1. Agarwal A, Gautam A, Rastogi S, Malviya D, Das PK, Harjai M. Effect of celiac plexus neurolysis for pain relief in patients with upper abdominal malignancy: a retrospective observational study and review of literature. Indian J Palliat Care. 2020;26:512–517. doi: 10.4103/IJPC.IJPC_37_20. - DOI - PMC - PubMed
    1. Qin W, Li Y, Liu B, Liu Y, Zhang Y, Zhang X, et al. Intrathecal morphine infusion therapy via a percutaneous port for refractory cancer pain in china: an efficacy, safety and cost utilization analysis. J Pain Res. 2020;13:231–237. doi: 10.2147/JPR.S233905. - DOI - PMC - PubMed

LinkOut - more resources