Alix School of Medicine, Mayo Clinic, Scottsdale, AZ, 85259.
Department of Radiology, Mayo Clinic, 5779 E Mayo Blvd, Phoenix, AZ, 85054.
Acad Radiol. 2021 Nov;28 Suppl 1:S244-S249. doi: 10.1016/j.acra.2021.03.005. Epub 2021 Apr 8.
Celiac plexus and retrocrural splanchnic nerve (CP/RSN) blocks are widely used for cancer-related abdominal pain, but there is limited literature on their efficacy for non-cancer related pain. Our aim was to determine the indications and effectiveness of CT-guided CP/RSN blocks performed on patients with abdominal pain from non-cancer related sources.
CT-guided CP/RSN blocks for non-cancer related abdominal pain from 2011-2020 were retrospectively reviewed for patient demographics, procedure details, duration of pain relief, and complications. Effective blocks were defined as patient-reported pain relief or decrease in opioid use lasting 2 or more days for temporary blocks and 14 or more days for permanent blocks.
Of 72 CT-guided CP/RSN blocks for non-cancer related abdominal pain, 48 (67%) were effective for a mean of 51 days (median 14, range 2-700). Of the 18 permanent blocks, 9 (50%) were effective for a mean of 111 days (median 90, range 14-390). Of the 54 temporary blocks, 39 (72%) were effective for a mean of 37 days (median 9, range 2-700). Indications included postural orthostatic tachycardia syndrome/dysautonomia (77% effective, 20/26), pancreatitis (86% effective, 12/14), postsurgical pain (62% effective, 8/13), median arcuate ligament syndrome (70% effective, 7/10), chronic pain syndrome (20% effective, 1/5), gastroparesis (80% effective, 4/5), and renal cystic disease (33% effective, 1/3). For postural orthostatic tachycardia syndrome /dysautonomia, pancreatitis, post-surgical pain, and MALS, there were no statistically significant differences in effectiveness between celiac vs. splanchnic blocks in groups matched by indication and intended duration (temporary/permanent).
CT-guided CP/RSN blocks can effectively manage non-cancer related abdominal pain, though there is discrepancy in efficacy between temporary and permanent blocks.
腹腔神经丛和 retrocrural 内脏神经（CP/RSN）阻滞被广泛用于治疗与癌症相关的腹痛，但关于其对非癌症相关疼痛的疗效的文献有限。我们的目的是确定 CT 引导的 CP/RSN 阻滞在治疗非癌症相关来源腹痛患者中的适应证和有效性。
回顾性分析 2011 年至 2020 年 CT 引导的 CP/RSN 阻滞治疗非癌症相关腹痛患者的患者人口统计学资料、手术细节、疼痛缓解持续时间和并发症。有效阻滞定义为患者报告的疼痛缓解或阿片类药物使用减少持续 2 天或以上的临时阻滞和 14 天或以上的永久阻滞。
72 例 CT 引导的 CP/RSN 阻滞治疗非癌症相关腹痛中，48 例（67%）有效，平均持续时间为 51 天（中位数 14 天，范围 2-700 天）。18 例永久性阻滞中，9 例（50%）有效，平均持续时间为 111 天（中位数 90 天，范围 14-390 天）。54 例临时阻滞中，39 例（72%）有效，平均持续时间为 37 天（中位数 9 天，范围 2-700 天）。适应证包括体位性心动过速综合征/自主神经功能紊乱（77%有效，26/34）、胰腺炎（86%有效，14/16）、术后疼痛（62%有效，13/21）、正中弓状韧带综合征（70%有效，10/14）、慢性疼痛综合征（20%有效，5/25）、胃轻瘫（80%有效，5/6）和肾囊肿性疾病（33%有效，3/9）。对于体位性心动过速综合征/自主神经功能紊乱、胰腺炎、术后疼痛和 MALS，在按适应证和预期持续时间（临时/永久）匹配的情况下，腹腔神经丛阻滞与内脏神经阻滞的有效性无统计学差异。
CT 引导的 CP/RSN 阻滞可以有效治疗非癌症相关的腹痛，尽管临时和永久性阻滞的疗效存在差异。
