Introduction. The insufficient analgesic effect obtained by using WHO pain management methods with respect to alleviating cancer pain directs researchers’ attention to invasive methods that could be used to supplement pharmacological ones or instead. One of such methods is the neurodestruction of the coeliac plexus (NCP) caused by the use of the chemical substances. The aim of the study was to assess the efficacy of the intraoperative coeliac plexus block in patients undergoing surgery due to the presence of epigastric tumour.
Materials and methods. Chemical neurolysis of the coeliac plexus was performed in 20 patients selected from a group of 86 patients suffering from severe pain who had a surgically confirmed presence of a tumour in the epigastrium, where no technical possibilities for tumour removal existed. The neurodestruction of the coeliac plexus was performed by using 40 ml of a local anesthetic - 0.5% bupivacaine mixed 1:1 with 98% alcohol. The efficacy of the block was monitored over 90 days using VAS, NRS and Melzack’s questionnaire.
Results. Following the neurodestruction of the coeliac plexus, 13 patients (65%) presented the significant reduction of pain symptoms. Throughout the three-month observation, virtually painless course of the disease was observed in 4 patients (20%). In 35% of cases (7 persons) the effect of the block was assessed as insufficient, whereas in 4 patients in this group no therapeutic effect was achieved. The mean VAS values for the entire group subjected to the chemical neurolysis (20 patients) were reduced from 5.81 to 2.98 (NRS from 6.00 to 3.01, respectively).
Conclusions. The efficacy of the intraoperative neurodestruction of the coeliac plexus performed in order to reduce pain in patients with epigastric tumours is comparable with transcutaneous techniques and may be an alternative to the pharmacological treatment.