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Abstract Background Celiac plexus block has been commonly utilized for the treatment of chronic pancreatitis-associated abdominal pain. Prospective studies suggest efficacy in 30 to 50% of patients, although no randomized sham-controlled trials have been performed. The objective of this study is to assess the effect of endoscopic ultrasound (EUS)-guided celiac plexus block on abdominal pain in patients with documented chronic pancreatitis. Methods This is a two-arm randomized sham-controlled trial with blinded evaluators. The study will be conducted at multiple academic sites in the United States who are members of the United States Pancreatic Disease Study Group (USPG). Patients referred for EUS to exclude chronic pancreatitis as a cause of abdominal pain as well as those with established painful chronic pancreatitis undergoing EUS for another indication will be eligible. At the time of EUS with confirmation of chronic pancreatitis by standard EUS diagnostic criteria, patients will be randomized to either celiac plexus block or sham whereby an anesthetic and steroid combination will be injected into the celiac plexus or saline will be injected into the gastric lumen with the same type of needle as used for celiac plexus block, respectively. The main outcome measure will be a 50% reduction in abdominal pain using the Brief Pain Inventory Short Form (BPI-SF) at 1 month post-intervention. A number of secondary outcomes will be measured including visual analog scale (VAS), Comprehensive Pain Assessment Tool Short Form (COMPAT-SF) pain scores, and quality of life using a pancreas-specific validated measure (PANQOLI). Discussion In this study, the effect of celiac plexus block on abdominal pain in patients with chronic pancreatitis will be compared to a sham intervention. This randomized trial will offer a definitive assessment of the role of celiac plexus block for the treatment of abdominal pain in this setting. Trial registration {2} ClinicalTrials.gov NCT 06178315. Registered on December 21, 2023

Background: Celiac plexus block has been commonly utilized for the treatment of chronic pancreatitis-associated abdominal pain. Prospective studies suggest efficacy in 30 to 50% of patients, although no randomized sham-controlled trials have been performed. The objective of this study is to assess the effect of endoscopic ultrasound (EUS)-guided celiac plexus block on abdominal pain in patients with documented chronic pancreatitis. Methods: This is a two-arm randomized sham-controlled trial with blinded evaluators. The study will be conducted at multiple academic sites in the United States who are members of the United States Pancreatic Disease Study Group (USPG). Patients referred for EUS to exclude chronic pancreatitis as a cause of abdominal pain as well as those with established painful chronic pancreatitis undergoing EUS for another indication will be eligible. At the time of EUS with confirmation of chronic pancreatitis by standard EUS diagnostic criteria, patients will be randomized to either celiac plexus block or sham whereby an anesthetic and steroid combination will be injected into the celiac plexus or saline will be injected into the gastric lumen with the same type of needle as used for celiac plexus block, respectively. The main outcome measure will be a 50% reduction in abdominal pain using the Brief Pain Inventory Short Form (BPI-SF) at 1 month post-intervention. A number of secondary outcomes will be measured including visual analog scale (VAS), Comprehensive Pain Assessment Tool Short Form (COMPAT-SF) pain scores, and quality of life using a pancreas-specific validated measure (PANQOLI). Discussion: In this study, the effect of celiac plexus block on abdominal pain in patients with chronic pancreatitis will be compared to a sham intervention. This randomized trial will offer a definitive assessment of the role of celiac plexus block for the treatment of abdominal pain in this setting. Trial registration {2}: ClinicalTrials.gov NCT 06178315. Registered on December 21, 2023 [ABSTRACT FROM AUTHOR]

The article presents a case study of a 61-year-old female with chronic focal abdominal pain successfully treated with botulinum toxin A (BoNT-A) in a celiac plexus block. Topics discussed include the mechanism of BoNT-A in pain management, the effectiveness of celiac plexus blocks for abdominal pain, and the significant reduction in pain and medication use experienced by the patient.

ObjectiveTo investigate the short-term efficacy of celiac plexus block combined with the interstitial permanent implantation of 125I seeds in the treatment of advanced pancreatic cancer (inoperable locally advanced and metastatic pancreatic cancers). MethodsA total of 100 patients with advanced pancreatic cancer were selected and treated with celiac plexus block combined with the interstitial permanent implantation of 125I seeds under CT guidance. Pain relief and changes in the tumor marker CA19-9 were assessed on the seventh day, the first and third months after surgery. In the third month after surgery, tumor size was assessed by CT. ResultsAmong the 100 patients with advanced pancreatic cancer, complete response (CR) was found in 12 cases, partial response (PR) in 78 cases, stable disease in five cases, and progression of disease in five cases three months after surgery. The CA19-9 level and the sum of short and long tumor diameters were significantly decreased (both P

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Background and Objectives: Patients now live longer thanks to advanced cancer treatments and early cancer identification. In this study, the efficacy of celiac plexus and splanchnic nerve blocks for pain management and quality of life in patients with upper abdominal malignancies at three months is compared. Material and Methods: This prospective, randomized trial compared the efficaciousness of a splanchnic nerve block vs a celiac plexus block for managing excruciating pain, as well as the side effects associated with both neurolytic blocks. This study was carried out at the Department of Anaesthesiology, Kurnool Medical College, Andhra Pradesh, India. From the patients who are part of this investigation, informed permission was acquired. Using data from the pilot study conducted between August 2022 to July 2023, a sample size of 20 was chosen. Results: Out of 60, a total of 20 patients that were evaluated for eligibility, 10 individuals were found to not meet the necessary inclusion criteria, while an additional 10 patients chose not to partake in the study. A total of sixty patients were randomly assigned to groups over the course of the trial. Group SNB consisted of 10 patients, while Group CPB also included 10 patients. In order to elucidate the descriptive data statistics, the frequency analysis method was employed for categorical variables, while the mean and standard deviation were utilized for continuous variables. Conclusion: The statistical data and findings of this study demonstrate that a splanchnic nerve block exhibits clinical comparability to a celiac plexus block, but with statistically significant discrepancies that hold little clinical significance. [ABSTRACT FROM AUTHOR]

Pancreatic cancer is often diagnosed at an advanced stage and is frequently associated with severe pain. Traditional pain management in this condition may be improved with the use of topical diclofenac. A 39-year-old man with advanced pancreatic fibrosarcoma metastatic to the thoracic spine presented to the hospital with severe abdominal pain refractory to escalating doses of opioids. A celiac plexus block produced significant, yet inadequate, pain reduction. Satisfactory pain control and opioid de-escalation were ultimately achieved with the application of topical diclofenac gel to an area of bony metastasis. This case illustrates the potential for pain control using topical diclofenac in patients with pancreatic soft tissue tumors and vertebral metastases. Topical diclofenac may exert antitumoral effects and targeted application may improve absorption, leading to improved pain control. The use of topical diclofenac for pain management in metastatic pancreatic cancer presents an interesting tool that should be considered in similar cases. [ABSTRACT FROM AUTHOR]

Abstract Background The major indication for celiac plexus block is abdominal pain that is nonresponsive to analgesic interventions; often these patients are nonresponsive to high-dose opioid therapies. One of the most common indications for the celiac plexus block is the treatment of abdominal pain associated with pancreatic cancer. Aim of the work The differences between two techniques (ultrasound and fluoroscopy guided) are highlighted in terms of effectiveness by means of a Visual Analog Scale (VAS), a percentage reduction in daily morphine consumption and any complications are recorded and evaluated at the time of implementation of each technique from start to finish. Results Through the data that have been recorded and statistically analyzed, we found that the mean values of VAS were decreased in the two groups, and there was statistically significant difference between ultrasound and fluoroscopy groups. Conclusions It is noticeable and good in conducting this research that there are no major complications that include a large space on the study sample, despite the presence of some minor with no significant differences between ultrasound and fluoroscopy groups. This effective celiac block, regardless of the technique used, produced immediate analgesics that permitted significant opioid decrease in the study sample with a significant improvement in the unwanted adverse effects on account of opioids.

The indication for the application of invasive procedures in the therapy of cancer pain is lack of response to opioids or patients who have side effects to opioid therapy that significantly impair the quality of life. Invasive treatment of cancer pain should not be the last resort but should be an integrative part in the treatment of cancer pain in combination with opioid therapy as a part of multimodal therapy. For visceral pain, interventional techniques represent a minimally invasive and reliable option for many diagnoses where active treatment options have been exhausted. There is evidence for the effectiveness of the celiac plexus block in pain treatment for pancreatic cancer and some upper abdominal cancers. According to research, the hypogastric neurolytic block is an option for pelvic visceral pain treatment and has proven to be more effective than oral opioid pain treatment. Recently, progress has been made with intrathecal and epidural analgesia as safe and effective therapeutic options with a positive risk-benefit ratio for cancer pain treatment over a long period of time and in home settings. Invasive procedures are a safe and effective option for cancer pain therapy, thus significantly affecting the quality of life.

Purpose: To evaluate the clinical efficacy of celiac plexus block (CPB) combined with 125I seeds implantation (ISI) for refractory epigastric pain from abdominal malignancies. Methods: The data of 81 patients with refractory epigastric pain [visual analog scale (VAS) score ≥ 4] from abdominal malignancies were collected in this retrospective case–control study. Group A (n = 40) was treated with CPB alone, while Group B (n = 41) underwent CPB combined with ISI. The primary study endpoints were the VAS score, quality of life (QoL), and local tumor control (LTC) rate. The secondary endpoints were complications, progression-free survival (PFS), and overall survival (OS). Results: The VAS scores at week 2 (T2), week 4 (T4), week 8 (T8), and week 12 (T12) in both groups were significantly lower compared with the pretreatment values (all P < 0.01). VAS scores in Group B showed a sustained decrease, especially for "mild pain" and "moderate pain," while the VAS scores in Group A rebounded at T8 and T12 (both P < 0.01). The QoL in Group B improved significantly from T4 until T12, which better than that at T12 in Group A (all P < 0.01). The LTC rates at T8 were 35.0% and 92.7% in Groups A and B, respectively, with a significant difference (P < 0.01). Group B had a slightly lower complication rate and a slightly longer median PFS/OS than group A, but neither was statistically different (P = 0.09 and P = 0.99, respectively). Conclusion: CPB combined with ISI performs more sustained pain relief (up to 12 weeks) compared to CPB alone, and ultimately improves the patients' QoL. [ABSTRACT FROM AUTHOR]

Background: The major indication for celiac plexus block is abdominal pain that is nonresponsive to analgesic interventions; often these patients are nonresponsive to high-dose opioid therapies. One of the most common indications for the celiac plexus block is the treatment of abdominal pain associated with pancreatic cancer. Aim of the work: The differences between two techniques (ultrasound and fluoroscopy guided) are highlighted in terms of effectiveness by means of a Visual Analog Scale (VAS), a percentage reduction in daily morphine consumption and any complications are recorded and evaluated at the time of implementation of each technique from start to finish. Results: Through the data that have been recorded and statistically analyzed, we found that the mean values of VAS were decreased in the two groups, and there was statistically significant difference between ultrasound and fluoroscopy groups. Conclusions: It is noticeable and good in conducting this research that there are no major complications that include a large space on the study sample, despite the presence of some minor with no significant differences between ultrasound and fluoroscopy groups. This effective celiac block, regardless of the technique used, produced immediate analgesics that permitted significant opioid decrease in the study sample with a significant improvement in the unwanted adverse effects on account of opioids. [ABSTRACT FROM AUTHOR]

Although celiac plexus block (CPB) is a well known technique that has been performed for years, only in the last 30 years controlled studies, demonstrated its efficacy and safety. A historical pathway of literature regarding CPB and a critical analysis may help understand some points which remain still controversial, for a better interpretation of data. [ABSTRACT FROM AUTHOR]

Introduction: Celiac plexus neurolysis (CPN) has been developed as adjunctive therapy to medical management (MM) of abdominal pain associated with unresectable pancreatic cancer. We aimed to conduct a systematic review and meta‐analysis to obtain updated and more accurate evidence on the efficacy of additional types of CPN, including endoscopic ultrasound‐guided CPN (EUS‐CPN). Methods: On March 16, 2021, we performed searches of PubMed, Web of Science, and CENTRAL for original randomized controlled trials (RCTs). We defined the primary outcome as a standardized pain intensity score with a range of 0–10, and evaluated the mean difference between the CPN + MM and MM groups at 4, 8, and 12 weeks after the initiation of treatment. We used a random‐effects model to synthesize the mean differences across RCTs. Results: We selected 10 RCTs involving 646 individuals. The synthesized mean difference in the pain intensity score between the CPN + MM and MM groups was −0.58 (95% confidence interval [CI]: −1.09 to −0.07) (p = 0.034) in favor of CPN + MM at 4 weeks, −0.46 (95%CI: −1.00 to 0.08) (p = 0.081) at 8 weeks, and − 1.35 (95%CI: −3.61 to 0.92) (p = 0.17) at 12 weeks. Conclusions: This updated meta‐analysis of CPN demonstrates its efficacy for managing abdominal pain at 4 weeks. Although there are various limitations, when abdominal pain in patients with unresectable pancreatic cancer is poorly controlled with MM alone, CPN should be an option even if the duration of effect is short‐lived, taking into account the absence of serious adverse events. [ABSTRACT FROM AUTHOR]

Computed tomography (CT)-guided celiac plexus block (CPB) is an effective intervention for pain management in the setting of pancreatic cancer. In these cases, nurses within the interventional radiology department are essential in all aspects of patient care before, during, and after the procedure. This article describes the treatment and management of a patient with stage IV metastatic pancreatic cancer. This article will discuss background information, relevant anatomy, indications, complications, contradictions, and nursing considerations for CT-guided CPB. • Celiac plexus block can relieve intractable pain from pancreatic cancer. • Common side effects of the block include orthostatic hypotension and diarrhea. • Nursing care is important for sedation and treatment of side effects. [ABSTRACT FROM AUTHOR]

Chronic abdominal visceral pain management often requires multidisciplinary collaboration. Image-guided visceral nerve interventions may be critical in the management of visceral pain refractory to medical treatments. Abdominal and pelvic pain is mediated by specific nerves involving specific ganglia. The well-defined location of these ganglia provides important targets for percutaneous image-guided interventions to alleviate chronic abdominal or pelvic pain. In this review, we provide an in-depth discussion of the anatomy, indications, evidence, and technical and clinical considerations and complications for celiac plexus, superior hypogastric, inferior hypogastric, and ganglion impar block and neurolysis. [ABSTRACT FROM AUTHOR]

Abdominal pain related to pancreatic disease is often extremely disabling. Endoscopic ultrasound (EUS)-guided celiac plexus block (CPB) is used to control pain associated with chronic pancreatitis. EUS-guided celiac plexus neurolysis (CPN) is typically used to reduce pain associated with pancreatic cancer and can be considered early at the time of diagnosis of inoperable disease. EUS-guided celiac plexus interventions have been shown to be significantly effective in pancreatic pain relief, which is achieved in approximately 70–80% of patients with pancreatic cancer and in 50–60% of those with chronic pancreatitis. Serious complications from CPB and CPN are rare. Most frequent adverse events are diarrhoea, orthostatic hypotension, and a transient increase in abdominal pain. In this article, the Portuguese Group for Ultrasound in Gastroenterology (GRUPUGE) presents an updated perspective of the potential role of EUS-guided celiac plexus interventions, addressing the selection criteria and technical issues of different techniques and analysing recent data on their safety and efficacy.

Kai Ji,1 Yue-Juan Shao,1 Jian-Lei Hao,1 Xian-Jiang Cheng,1 Bing-Qing Guan,1 Wei-Shuai Liu,1 Lei Chen,1 Xin Wang,2 Yong-Chun Song,2 Kun Wang,1 Ping Wang2 1Department of Pain Relief, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, and Tianjin’s Clinical Research Center for Cancer, Tianjin, People’s Republic of China; 2Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, and Tianjin’s Clinical Research Center for Cancer, Tianjin, People’s Republic of ChinaCorrespondence: Ping Wang Email wangping@tjmuch.comPurpose: This study evaluated the analgesic effect of stereotactic body radiotherapy (SBRT) in combination with celiac plexus block (CPB), relative to SBRT alone, in locally advanced pancreatic cancer (LAPC) patients.Patients and Methods: We reviewed medical records of all patients with LAPC, who received SBRT between 1 January 2017 to 31 August 2019 at our center. The average numeric rating scale (NRS) of ≥ 3 was used in all patients at admission. We recorded average and worst NRS in a 24-hour period, and daily narcotic doses before SBRT, followed by weekly for 1 month and monthly for 3 months.Results: A total of 23 patients in the SBRT group and 12 under SBRT+CPB who met the inclusion criteria were enrolled. All patients in the SBRT+CPB group received CPB within 10 days after SBRT. Pain intensity and narcotic consumption were comparable in both groups at initial assessment. However, a significant decrease (P < 0.05) in average NRS was recorded in the SBRT+CPB group relative to SBRT at 2, 3 and 4 weeks after SBRT. A comparison of daily narcotic consumption with baseline values showed a significant decrease in the SBRT+CPB group at 3 and 4 weeks after SBRT (P < 0.05), while no significant differences were observed in the SBRT group.Conclusion: CPB after SBRT appears to be an effective therapeutic option in patients with LAPC and warrants further evaluation with increased number of patients in prospective clinical trials.Keywords: cancer pain, celiac plexus block, stereotactic body radiotherapy, locally advanced pancreatic cancer

Congenital diaphragmatic hernia (CDH) is a condition in which a developmental defect in the diaphragm leads to protrusion of abdominal contents into the thoracic cavity. Its definitive management is by surgical repair. Postoperative analgesia is crucial following the surgery as inadequate analgesia is a major contributing factor for postoperative pulmonary complications in these patients. Systemic analgesics with or without regional techniques such as epidural analgesia have been the mainstay of postoperative pain management following surgical correction of the defect. We report the case of a child with right-sided Morgagni hernia who underwent surgical repair under general anesthesia. For postoperative analgesia, right erector spinae plane block (ESPB) along with right celiac plexus block (CPB) was performed under ultrasound guidance with excellent results. We observed that ESPB combined with CPB provides excellent analgesia following repair of CDH.

Celiac plexus block (CPB) has been widely used as a treatment option for chronic intractable abdominal pain resulting from intra-abdominal malignancies as well as benign conditions. Complications resulting from CPB have been long reported and include diarrhea, back pain, paraplegia, postural hypotension, pneumothorax, and local anesthesia toxicity. Diarrhea and postural hypotension are two most common complications with studies reporting incidences occurring in 44% to 60% and 10% to 52% of patients, respectively. Diarrhea is most often transient, resolving within 48 hours; however, literature reports cases in which diarrhea was chronic, debilitating, and in some instances life threatening. Persistent diarrhea proves difficult to treat. We report a case of a 76-year-old male with unresectable pancreatic adenocarcinoma who underwent computed tomography-guided CBP complicated by persistent diarrhea and fecal incontinence. After conventional antidiarrheal failed to improve the symptoms, octreotide proved to be beneficial and the patient reported significant improvement in symptoms. [ABSTRACT FROM AUTHOR]

Cancer survivors often face persistent abdominal pain, necessitating optimal pain management. While celiac plexus block (CPB) and botulinum toxin (BT) injection are viable options, traditional methods may encounter challenges due to patient-specific concerns and anatomical complexities. Here, the case of a cancer survivor in his 70 s experiencing recurrent abdominal pain, who declined conventional percutaneous CPB approaches due to anxiety related to aortic puncture, is presented. Following a pancreaticoduodenectomy, the patient developed chronic abdominal pain attributed to adhesions leading to small bowel obstruction. Concurrently, there was notable psychological distress, including anxiety, depression, and heightened concerns regarding tumor recurrence. Considering the patient's specific concerns, a right-sided unilateral retrocrural single-needle technique was proposed, aimed at alleviating pain, while avoiding conventional CPB approaches. Initial right-sided retrocrural CPB offered short-term relief, prompting a subsequent BT injection using the same approach. Following BT injection, the patient reported significant and sustained pain reduction (from 8 to 1 on an 11-point numerical rating scale) at both 12 and 20 weeks post-procedure. Right-sided retrocrural BT injection offers an alternative approach, addressing patient concerns and demonstrating prolonged pain relief. This may benefit cancer survivors with upper abdominal pain, emphasizing the importance of personalized and innovative pain management strategies., Competing Interests: Declaration of conflicting interestThe authors declare that there is no conflict of interest.

Pain secondary to chronic pancreatitis is a poorly understood and complex phenomenon. Current endoscopic treatments target pancreatic duct decompression secondary to strictures, stones, or inflammatory and neoplastic masses. When there is refractory pain and other treatments have been unsuccessful, one can consider an endoscopic ultrasound-guided celiac plexus block. Data on the latter are underwhelming., Competing Interests: Disclosure A. Kundra and D.S. Strand has nothing to disclose. V.M. Shami: Consultant for Cook Medical, Olympus America, and Boston Scientific., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Pain is the most common reason for presentation of a patient to a physician suffering from upper abdominal pathologies such as pancreatitis, benign tumors, or malignancies of liver/gall bladder/stomach/colon. Inflammation, scarring, and increased pancreatic duct pressure or malignant invasion of celiac plexus are the major causes of pain. A comprehensive evaluation of the patient for pain, associated pathological problem, and to find out any surgical indication is necessary. We present a 55-year-old female patient diagnosed of liver hemangioma with right upper abdominal pain. Treatment options of embolization under radiological guidance and/or surgical resection–enucleation were not acceptable and affordable to the patient. The patient was then referred for upper right intra-abdominal pain management. Following informed consent and vital monitoring inside the operation theater, the patient was given prone position. Under aseptic precautions and fluoroscopy guidance, diagnostic celiac plexus block was given on the right side with 5 ml of 2% lignocaine with adrenaline + 20 ml of 0.25% bupivacaine + fentanyl 25 μg at the level of L1 body of vertebra, which resulted in 80% of relief in pain for 18 h. Later, this was followed by neurolytic block using 15 ml of 8% phenol after injection of 10 ml of 0.25% bupivacaine to confirm the effective pain relief. Numerical Rating Scale score decreased from 7 to 2 at 1 week. Seventy-five percent of pain relief was present at the 6th month of follow-up. There was significant improvement in quality of life and sleep. Single-needle technique of celiac plexus block is a useful method for the control of chronic upper abdominal pain due to liver pathology.

Both oncological and benign chronic abdominal pain have a very high prevalence, being even higher in pancreatic and gastric oncological disease. This type of pain can be very disabling and difficult to treat. The Celiac Plexus Block (CPB) has been used as an alternative in multimodal treatment in cancer patients and in non-cancer related pain. We present the case of an 11-year-old boy, with no relevant history, presenting with 18-month epigastric abdominal pain is discussed, with an initial diagnosis of acute pancreatitis, confirmed by complementary test, Magnetic Resonance Imaging (MRI). The pain was disabling, impacted the daily life of the patient and was refractory to treatment with conventional analgesia and weak opioids. In the follow-up MRI study, no signs suggestive of acute or chronic pancreatitis were found. The patient was referred to the Pain Unit for analgesic optimization and performance of a CPB as a therapeutic alternative. The procedure was performed under general anesthesia guided by computerized axial tomography (CT) using a posterior para-aortic approach, with administration of local anesthetic and steroids. The patient presented remission of pain that he still maintains. CPB is a technique that has shown its usefulness in the treatment of chronic abdominal pain in adults, however, in the pediatric population the strength of the evidence is lower in relation to the special considerations that must be taken into account. However, it is considered that CPB may be a resource in the treatment of refractory pain of non-oncological etiology in selected pediatric patients. [ABSTRACT FROM AUTHOR]

What is known and objective: The botulinum toxin (BoNT) has been widely used for various conditions associated with pain. Case description: Here, we report a case where celiac plexus block (CPB) with BoNT relieved intractable chronic pancreatic pain without complications. CPB was performed at the L1 level under fluoroscopic guidance, and 50 IU BoNT was injected on each side. After 15 weeks, pain was decreased to 0/10 on a visual analogue scale, without opioids or tramadol. What is new and conclusion: Our case demonstrates the efficacy of CPB with BoNT in intractable pain due to severe chronic pancreatitis. [ABSTRACT FROM AUTHOR]

Purpose Of Review: Chronic abdominal pain (CAP) is a significant health problem that can dramatically affect quality of life and survival. Pancreatic cancer is recognized as one of the most painful malignancies with 70-80% suffering from substantial pain, often unresponsive to typical medical management. Celiac plexus neurolysis and celiac plexus block (CPB) can be performed to mitigate pain through direct destruction or blockade of visceral afferent nerves. The objective of this manuscript is to provide a comprehensive review of the CPB as it pertains to CAP with a focus on the associated anatomy, indications, techniques, neurolysis/blocking agents, and complications observed in patients who undergo CPB for the treatment of CAP.Recent Findings: The CAP is difficult to manage due to lack of precision in diagnosis and limited evidence from available treatments. CAP can arise from both benign and malignant causes. Treatment options include pharmacologic, interventional, and biopsychosocial treatments. Opioid therapy is typically utilized for the treatment of CAP; however, opioid therapy is associated with multiple complications. CPB has successfully been used to treat a variety of conditions resulting in CAP. The majority of the literature specifically related to CPB is surrounding chronic pain associated with pancreatic cancer. The literature shows emerging evidence in managing CAP with CPB, specifically in pancreatic cancer. This review provides multiple aspects of CAP and CPB, including anatomy, medical necessity, indications, technical considerations, available evidence, and finally complications related to the management. [ABSTRACT FROM AUTHOR]

Upper abdominal pain caused by chronic pancreatitis is one of the most debilitating symptoms caused by this disease; its treatment and approach is one of the most important aspects. Treatment of pancreatic pain follows the World Health Organization therapeutic scale, starting with nonsteroidal anti-inflammatory drugs and progressing with adjuvants, and finally adding opioids. When pain management is insufficient despite the prescribed medication or adverse effects are intolerable, it is advisable to search for therapeutic alternatives and, within them, celiac plexus block may be indicated. Celiac plexus block with steroids and/or local anesthetics is the technique used to temporarily inhibit the plexus functions in patients with a benign disease such as chronic pancreatitis. This technique is highly effective with early pain relief, it is safe, and performed by expert anesthesiologists has a low complication rate. [ABSTRACT FROM AUTHOR]