Computed Tomography Versus Fluoroscopy Guidance in Celiac Plexus Neurolysis for Treatment of Upper Abdominal Malignant Pain

Background: Visceral cancer pain from upper abdominal viscera (pancreas, liver, gall bladder and stomach) may be abolished by a Neurolytic Celiac Plexus Block (NCPB). The purpose of this study is to highlight differences between two techniques as regard efficacy by means of Visual Analogue Scale (VAS), percent reduction in daily morphine consumption. Methods: 60 patients with pancreatic cancer pain for which pharmacological treatment (NSAIDs and opioids) proved either ineffective or limited by side effects were randomly allocated into two groups. Study was done over eighteen months from January 2013 to June 2014. Each patient is assessed by linear Visual Analogue Scale (VAS) and percent reduction in daily morphine consumption. All evaluation parameters were done before the block, at day (0) 2hr post block, 2 days, 2 weeks and 3 weeks post block. Results: The parameters were comparable with no significance difference between both techniques (p-value^!0.05). Conclusion: We concluded that an effective NCPB, regardless of the technique used, produce immediate analgesia and allowed a reduction in opioid dose.