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The Role of Endoscopic Ultrasound in Pain Management

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Diagnostic and Therapeutic Procedures in Gastroenterology

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Abstract

Pain is one of the most common symptoms that leads to medical evaluation. The international association for the study of pain, IASP, defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (Merskey and Bogduk 1994). Numerous national and international surveys have demonstrated that 60–90% of patients with cancer develop pain in the natural history of disease. Some cancer pain syndromes tend to be intractable secondary to the nature of pain, and also due to comorbid medical as well as psychological factors associated with serious illness, terminal prognosis, and dying (Reddy and Shanti 2004).

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References

  • Merskey H, Bogduk N. Classification of chronic pancreatitis. Seattle: IASP press; 1994.

    Google Scholar 

  • Reddy SK, Shanti BF. Cancer pain: assessment and management. Prim Care Cancer. 2000;20:44–52.

    Google Scholar 

  • Patt RB. Classification of cancer pain and cancer pain syndromes. Edited by Patt RB. Philadelphia: Lippincot-Raven Publishers; 1993. p. 3–57.

    Google Scholar 

  • Kappis M. Erfahrungen mit local anasthesie bie bauchopertionen [German with English abstract]. Verh Dtsch Gesellsch Chir. 1914;43:87–9.

    Google Scholar 

  • Ventafridda GV, Caraceni AT, Sbanotto AM, et al. Pain treatment in cancer of the pancreas. Eur J Surg Oncol. 1990;16:1–6.

    PubMed  CAS  Google Scholar 

  • Lankisch PG. Natural course of chronic pancreatitis. Pancreatology. 2001;1:3–14.

    Article  PubMed  CAS  Google Scholar 

  • Eisenberg E, Carr DB, Chalmers TC. Neurolytic celiac plexus block for treatment of cancer pain: a meta-analysis. Anesth Analg. 1995;80:290–5. erratum 1995;81:213.

    PubMed  CAS  Google Scholar 

  • Usati M, Paquin SC, Dagenais M, et al. Preliminary results of a randomized, double blind, controlled trial of early EUS-guided celiac plexus neurolysis (EUS-CPN) versus conventional management for pain in patients with inoperable pancreatic cancer [abstract]. Gastrointest Endosc. 2008;68:AB211.

    Article  Google Scholar 

  • Newman PP. Visceral afferent functions of the nervous system. London: Arnold; 1974.

    Google Scholar 

  • Levy MJ, Topazian MD, Wiersema MJ, et al. Initial evaluation of the efficacy and safety of endoscopic ultrasound-guided direct Ganglia neurolysis and block. Am J Gastroenterol. 2008;103:98–103.

    Article  PubMed  Google Scholar 

  • Leblanc J, DeWitt J, Calley C, et al. A prospective randomized trial of 1 versus 2 injections during a single EUS-guided celiac plexus block for chronic pancreatitis pain. Gastrointest Endosc. 2009;69:835–42.

    Article  PubMed  Google Scholar 

  • Wiersema MJ, Wiersema LM. Endosonography guided celiac plexus neurolysis. Gastrointest Endosc. 1996;44:656–62.

    Article  PubMed  CAS  Google Scholar 

  • Wiersema MJ, Harada N, Wiersema LM. Endosonography guided celiac plexus neurolysis efficacy in chronic pancreatitis and malignant disease. Acta Endoscopia. 1998;28:67–79.

    Article  Google Scholar 

  • Gunaratnam NT, Sarma AV, Norton ID, Wiersema MJ. A prospective study of EUS-guided celiac plexus neurolysis for pancreatic cancer pain. Gastrointest Endosc. 2001;54:316–24.

    Article  PubMed  CAS  Google Scholar 

  • Ischia S, Ischia A, Polati B, Finco G. Three posterior percutaneous celiac plexus block techniques. A prospective, randomized study in 61 patients with pancreatic cancer pain. Anesthesiology. 1992;76:534–40.

    Article  PubMed  CAS  Google Scholar 

  • Gress F, Schmitt C, Sherman S, Ciccia D, Ikenberry S, Lehman G. Endoscopic ultrasound guided celiac plexus block for managing abdominal pain associated with chronic pancreatitis: a prospective single center experience. Am J Gastroenterol. 2001;96:409–16.

    Article  PubMed  CAS  Google Scholar 

  • Gress F, Schmitt C, Sherman S, Ikenberry S, Lehman G. A prospective randomized comparison of endoscopic ultrasound and computed tomography-guided celiac plexus block for managing chronic pancreatitis pain. Am J Gastroenterol. 1999;94:900–5.

    Article  PubMed  CAS  Google Scholar 

  • Gunaratnam NT, Wong GY, Wiersema MJ. EUS-guided celiac plexus block for the management of pancreatic pain. Gastrointest Endosc. 2000;52:S28–34.

    Article  PubMed  CAS  Google Scholar 

  • Chan VW. Chronic diarrhea: an uncommon side effect of celiac plexus block. Anesth Analg. 1996;82:205–7.

    PubMed  CAS  Google Scholar 

  • Cataldo R, Potash M. Atropine as a treatment of diarrhea after celiac plexus block. Anesth Analg. 1996;83:1131–2.

    PubMed  CAS  Google Scholar 

  • Mercadante S. Octreotide in the treatment of diarrhea induced by celiac plexus block. Pain. 1995;61:345–6.

    Article  PubMed  CAS  Google Scholar 

  • Iftikhar S, Loftus Jr EV. Gastroparesis after celiac plexus block. Am J Gastroenterol. 1998;93:2223–5.

    Article  PubMed  CAS  Google Scholar 

  • Gress F, Ciacca D, Kiel J, Sherman S, Lehman G. Endoscopic ultrasound (EUS) guided celiac plexus block (CB) for management of pain due to chronic pancreatitis (CP): a large single center experience. Gastrointest Endosc. 1997;45:AB173.

    Google Scholar 

  • Brass A. Anatomy and physiology: autonomic nerves and ganglia in pelvis. In: Netter FH, editor. The Ciba collection of medical illustrations, Nervous System, vol. 1. USA: Ciba Pharmaceutical Co; 1983. p. 85.

    Google Scholar 

  • Snell RS, Katz J. Clinical anatomy for anesthesiologists. Norwalk: Appleton and Lange; 1988. p. 271.

    Google Scholar 

  • Plancarte R, Amescua C, Patt R, et al. Superior hypogastric plexus block for pelvic cancer pain. Anesthesiology. 1990a;73:236.

    Article  PubMed  CAS  Google Scholar 

  • Waldman SD, Wilson WL, Kreps RD. Superior hypogastric plexus block using a single needle and computed tomography guidance: description of a modified technique. Reg Anesth. 1991;16:286.

    PubMed  CAS  Google Scholar 

  • Kanazi G, Perkins FM, Thakur R, Dotson E. New technique for superior hypogastric plexus block. Reg Anesth Pain Med. 1999;24:473–6.

    PubMed  CAS  Google Scholar 

  • Ayub K. EUS guided superior hypogastric plexus neurolysis: a new technique for management of pelvic pain. Gastrointest Endosc. 2001;53:AB113.

    Google Scholar 

  • Plancarte R, Amescua C, Patt RB, Aldrete JA. Superior hypogastric plexus block for pelvic cancer pain. Anesthesiology. 1990b;73:236–9.

    Article  PubMed  CAS  Google Scholar 

  • Plancarte R, Amescua C, Patt RB. Presacral blockade of the ganglion of Walther (ganglion impar). Anesthesiology 1990; 73:A751.

    Google Scholar 

  • Love MA, Varklet VL, Wilsey BL, Ferrante FM. Cryoablation: a novel approach to neurolysis of the ganglion impar block. Anesthesiology. 1998;88:1391–3.

    Article  Google Scholar 

  • Ayub K. A new approach to ganglion impar neurolysis using endoscopic ultrasound. Endoscopy. 2000;32 Suppl 1:244.

    Google Scholar 

  • Toshniwal GR, Dureja GP, Prashanth SM. Transsacrococcygeal approach to ganglion impar block for management of chronic perineal pain: a prospective observational study. Pain Physician. 2007;10:661–6.

    PubMed  Google Scholar 

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Correspondence to Kamran Ayub M.D., MRCP (UK) .

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Ayub, K. (2011). The Role of Endoscopic Ultrasound in Pain Management. In: Wu, G., Sridhar, S. (eds) Diagnostic and Therapeutic Procedures in Gastroenterology. Clinical Gastroenterology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59745-044-7_17

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  • DOI: https://doi.org/10.1007/978-1-59745-044-7_17

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  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-58829-478-4

  • Online ISBN: 978-1-59745-044-7

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