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Sympathetic and Celiac Plexus Blocks

  • Octavio Calvillo
  • Gabor B. Racz
  • Carl Noe
Chapter

Abstract

Sympathetic blocks are used for the treatment of pain when signs and symptoms of sympathetically maintained pain are present. Additional or alternative treatments are necessary for the care of many patients with complex regional pain syndromes. Celiac plexus blocks are used for the treatment of pain associated with pancreatic cancer and celiac blocks have been shown to have positive results in multiple randomized trials.

Keywords

Sympathetic block Complex regional pain syndrome Reflex sympathetic dystrophy Celiac block Pancreatic cancer 

References

  1. 1.
    Amr YM, Makharita MY. Comparative study between 2 protocols for management of severe pain in patients with unresectable pancreatic cancer; one- year follow-Up. Clini J Pain. 2013;29:807–13.CrossRefGoogle Scholar
  2. 2.
    Atkins RM, Duckworth T, Kanis JA. Algodystrophy following Colles’ fracture. J Hand Surg Br. 1989;14:161–4.CrossRefPubMedGoogle Scholar
  3. 3.
    Baron R, Naleschinski D, Hullemann P, Mahn F. Complex regional pain syndrome: a neuropathic disorder? In: Pain 2010 – an updated review: refresher course syllabus. Seattle: IASP Press; 2010. p. 109–17.Google Scholar
  4. 4.
    Bektas M, Atiq M, Bhutani MS. First report of celiac plexus block for refractory abdominal pain secondary to peripancreatic colon cancer metastasis. Gastrointest Endosc. 2012;76(3):692–3.CrossRefPubMedGoogle Scholar
  5. 5.
    Besse J, Gadeyene S, Galand-Desme S, et al. Effect of vitamin C on prevention of complex regional pain syndrome in foot and ankle surgery. Foot Ankle Surg. 2009;15:179–82.CrossRefPubMedGoogle Scholar
  6. 6.
    Bruehl S, Chung OY, Burns JW. Differential effects expressive anger regulation on chronic pain in CRPS and non-CRPS limb pain patients. Pain. 2003;104:647–54.CrossRefPubMedGoogle Scholar
  7. 7.
    Cacchio A, De Blasis E, De Blasis V, et al. Mirror therapy in complex regional pain syndrome type 1 of the upper limb in stroke patients. Neurorehabil Neural Repair. 2009;23:792–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Calvillo O, Racz GB, Diede J, Smith K. Neuroaugmentation in the treatment of complex Syst Rev regional pain syndrome of the upper extremity. Acta Orthop Belg. 1998;64–1:57–63.Google Scholar
  9. 9.
    Carroll I, Clark JD, Mackey S. Sympathetic block with botulinum toxin to treat complex regional pain syndrome. Annals of Neurology. 2009;65(3):348–51.Google Scholar
  10. 10.
    Cepeda MS, Carr DB, Lau J. Local anesthetic sympathetic blockade for complex regional pain syndrome. Cochrane Syst Rev. 2005;(4):CD004598.Google Scholar
  11. 11.
    Cerfolio RJ, De Campos JR, Bryant AS, Connery CP, Miller DL, DeCamp MM, McKenna RJ, Krasna MJ. The society of thoracic surgeons expert consensus for the surgical treatment of hyperhidrosis. Ann Thorac Surg. 2011;91(5):1642–8.CrossRefPubMedGoogle Scholar
  12. 12.
    Cheng JK, Ji RR. Intracellular signaling in primary sensory neurons and persistent pain. Neurochem Res. 2008;33:1970–8.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Christensen K, Jensen EM, Noer I. The eflex sympathetic dystrophy syndrome response to treatment with systemic corticosteroids. Acta Chir Scand. 1982;148:653–5.PubMedGoogle Scholar
  14. 14.
    Collins S, Zuurmond WWA, de Lange JJ, et al. Intravenous magnesium for Complex Regional Pain Syndrome Type 1 (CRPS1) patients: a Pilot Study. Pain Med. 2009;10:930–40.CrossRefPubMedGoogle Scholar
  15. 15.
    Cross FW, Cotton LT. Chemical lumbar sympathectomy for ischemic rest pain: a randomized prospective controlled clinical trial. Am J Surg. 1985;150(3):341–5.CrossRefPubMedGoogle Scholar
  16. 16.
    Day M. Sympathetic blocks. The evidence. Pain Prac. 2008;8:98–109.CrossRefGoogle Scholar
  17. 17.
    de Mos M, de Bruijn AG. The incidence of complex regional pain syndrome: a population-based. Pain. 2007;129:12.CrossRefPubMedGoogle Scholar
  18. 18.
    de Olivera RR, Exira MJ. Thoracic sympathetic block for the treatment of complex regional pain syndrome type 1: a double-blind randomized controlled study. Pain. 2014;155:2274–81.CrossRefGoogle Scholar
  19. 19.
    de Rooij AM, de Mos M, Stukernboom MC, Marinus J, Van den Magdenberg AM, van Hilten JJ. Family occurrence of complex regional pain syndrome. Eur J Pain. 2009;13:171–7.CrossRefPubMedGoogle Scholar
  20. 20.
    Drummond PD, Finch PM, Skipwork S, Blockey P. Pain increases during sympathetic arousal in patients with complex regional pain syndrome. Neurology. 2001;57:1296–303.CrossRefPubMedGoogle Scholar
  21. 21.
    Dunn KM, Saunders KW, Rutter CM, et al. Opioid prescriptions for chronic pain and overdose: a cohort study. Ann Intern Med. 2010;152:85–92.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Elahi F, Wu WY, Callahan D, Bhandary AK, Beutler BC. Lassalle, CA, Hemmings Jr HC, editors. Schwartz AJ, associate editor. Images in anesthesiology: reversible anterior spinal artery syndrome during celiac plexus block. Anesthesiology. 2013;118:187.Google Scholar
  23. 23.
    Feldman SI, Downey G. Schafer-Neitz: pain negative mood and perceived social support in chronic pain patients: a daily diary study of people with reflex sympathetic dystrophy. J Consult Clin Psychol. 1999;67:776–85.CrossRefPubMedGoogle Scholar
  24. 24.
    Gabrhelik T, Michalek P, Adamus M, Berta E. Percutaneous upper thoracic radiofrequency sympathectomy in Raynaud’s phenomenon – a comparison of T2/T3 procedure versus T2 lesion with phenol application. Reg Anesth Pain Med. 2009;34:425–9.CrossRefPubMedGoogle Scholar
  25. 25.
    Goebel A, Barker CH, Turner SL, et al. Complex regional pain syndrome in adults: UK guidelines for diagnosis, referral and management in primary and secondary care. London: RCP; 2012.Google Scholar
  26. 26.
    Goroszeniuk T, Warsaw LM, Riaz K. Permanent percutaneous splanchnic nerve neuromodulation for management of pain due to chronic pancreatitis: a case report. Neuromodulation. 2011;14:253–7.CrossRefPubMedGoogle Scholar
  27. 27.
    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.CrossRefPubMedGoogle Scholar
  28. 28.
    Grothusen JR, Alexander G, Erwin K, Schwartzman R. Thermal pain in complex regional pain syndrome. Pain Physician. 2014;17:71–9.PubMedGoogle Scholar
  29. 29.
    Harden RN, Oaklander AL, Burton AW, Perez RS, Richardson K, Swan M, Barthel J, Costa B, Graciosa JR, Bruehl S. Complex regional pain syndrome: practical diagnostic and treatment guidelines, 4th edition. Pain Med. 2013;14(2):180–229.CrossRefPubMedGoogle Scholar
  30. 30.
    Harden RN, Rudin NJ, Buehl S, Kee W, Parik DK, Kooch J, Duc T, Gracely RH. Increased systemic catecholamine in complex regional pain syndrome and relationship to psychological factors. Anesth Analg. 2004;99:1478–85.CrossRefPubMedGoogle Scholar
  31. 31.
    Haynsworth Jr RF, Noe CE. Percutaneous lumbar sympathectomy: a comparison of radiofrequency denervation versus phenol neurolysis. Anesthesiology. 1991;74(3):459–63.CrossRefPubMedGoogle Scholar
  32. 32.
    Heavner JE, Calvillo O, Racz GB. Thermal grill illusion and complex regional pain syndrome-type I reflex sympathetic dystrophy. Reg Anesth. 1997;22(3):257–9.CrossRefPubMedGoogle Scholar
  33. 33.
    Herrero JF, Laird JM, Lopez Garcia JA. Windup of spinal neurons and pain sensation: much ado about something? Prog Neurobiol. 2000;61:169–203.CrossRefPubMedGoogle Scholar
  34. 34.
    Horlocker T, Wedel D, Rowlingson D, et al. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Guidelines (3rd ed.). Reg Anesth Pain Med. 2010;35:64–101.CrossRefPubMedGoogle Scholar
  35. 35.
    Ji RR, Woolf CJ. Neuronal plasticity and signal transduction in nociceptive neurons: implications for the initiation and maintenance of pathological pain. Neurobiol Dis. 2001;8:1–10.CrossRefPubMedGoogle Scholar
  36. 36.
    Johnson CD, Berry DP, Harris S, Pickering RM, Davis C, George S, Imrie CW, Neoptlemos JP, Sutton R. An open randomized comparison of clinical effectiveness of protocol-driven opioid analgesia, celiac plexus block or thoracoscopic splanchnicectomy for pain management in patients with pancreatic and other abdominal malignancies. Pancreatology. 2009;9(6):755–63.CrossRefPubMedGoogle Scholar
  37. 37.
    Juottonen K, Gockel M, Sillen T, Hurri H, Fors N. Altered central sensory motor processing in patients with complex regional pain syndrome. Pain. 2002;98:315–23.CrossRefPubMedGoogle Scholar
  38. 38.
    Klemer MA, deVet HC, Barendse GAM, et al. Effect of spinal cord stimulation for chronic complex regional pain syndrome Type I: five–year follow-up of patients in a randomized controlled trial. J Neurosurg. 2008;108:292–8.CrossRefGoogle Scholar
  39. 39.
    Kramis RC, Roberts WJ, Gillette RG. Post–sympathectomy neuralgia: hypotheses on peripheral and central neuronal mechanisms. Pain. 1996;64(1):1–9.CrossRefPubMedGoogle Scholar
  40. 40.
    Maihofner C, Handwerker HO, Neundorfer B, Birklein F. Cortical reorganization during recovery from complex regional pain syndrome. Neurology. 2004;63(4):693–701.CrossRefPubMedGoogle Scholar
  41. 41.
    Mailis A, Furlan A. Sympathectomy for neuropathic pain. [Review] [18 refs] [Update in Cochrane Database Syst Rev. 2010;(7):CD002918; PMID: 20614432].Google Scholar
  42. 42.
    Manjunath PS, Jayalakshmi TS, Dureja GP, Prevost AT. Management of lower limb complex regional pain syndrome type 1: an evaluation of percutaneous radiofrequency thermal lumbar sympathectomy versus phenol lumbar sympathetic neurolysis-a pilot study. Anesth Analg. 2008;106(2):647–9. Table of Contents, 2008 Feb.CrossRefPubMedGoogle Scholar
  43. 43.
    Meier PM, Zurakowski D, Berde CB, Sethna NF. Lumbar sympathetic blockade in children with complex regional pain syndromes: a double blind placebo-controlled crossover trial. Anesthesiology. 2009;111(2):372–80.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Mitchel SW, Morehouse GR, Keen WW. Gunshot wounds and other injuries to nerves. Philadelphia: JB Lippincott & Co; 1864.Google Scholar
  45. 45.
    Moiset X, Boiusharia D. Brain imaging of neuropathic pain. Neuroimage. 2007;37(suppl):S80–8.CrossRefGoogle Scholar
  46. 46.
    Noe CE, Haynsworth Jr RF. Lumbar radiofrequency sympatholysis. J Vasc Surg. 1993;17(4):801–6.CrossRefPubMedGoogle Scholar
  47. 47.
    Oaklander AL, Rissmiller JG, Gelman LB, Zheng L, Chang Y, Gott R. Evidence of small- fiber axonal degeneration in complex regional pain syndrome type 1 [reflex sympathetic dystrophy]. Pain. 2006;120:244–66.CrossRefGoogle Scholar
  48. 48.
    Ochoa JL. Truths, errors and lies around “reflex sympathetic dystrophy”. J Neurol. 1999;246:875–9.CrossRefPubMedGoogle Scholar
  49. 49.
    Price DD, Long S, Wilsey B, Rafti A. Analysis of peak magnitude and duration of analgesia produced by local anesthetics injected into sympathetic ganglia of complex regional pain syndrome patients. Clin J Pain. 1998;14(3):216–26.CrossRefPubMedGoogle Scholar
  50. 50.
    Racz Gabor B, Heavner, James E, Noe, Carl E. Definitions, classification and taxonomy: an overview. Sympathetic pain syndromes: reflex sympathetic dystrophy and causalgia. Physical medicine and rehabilitation: State of the art reviews, vol. 10, no. 2. Philadelphia: Hanley and Belfus; 1996.Google Scholar
  51. 51.
    Rieger R, Loureiro Mde P, Pedevilla S, de Oliveira RA. Endoscopic lumbar sympathectomy following thoracic sympathectomy in patients with palmoplantar hyperhidrosis. World Journal of Surgery. 2011;35(1):49–53.Google Scholar
  52. 52.
    Roberts WJ. A hypothesis on the physiological basis for causalgia and related pains. Pain. 1986;24:297–311.CrossRefPubMedGoogle Scholar
  53. 53.
    Rykowski Jan J, Hilgier M. Efficacy of neurolytic celiac plexus block in varying locations of pancreatic cancer; influence on pain relief. Anesthesiology. 2000;92(2):347–54. 92547–54 0 2000, American Society of Anesthesiologists, Inc Lippincott Williams & Wilkins, Inc.CrossRefGoogle Scholar
  54. 54.
    Sandroni P. Benrud-Larson: complex regional pain syndrome type 1: incidence and prevalence in Olmstead county, a population-based study. Pain. 2003;109:199–207.CrossRefGoogle Scholar
  55. 55.
    Shah RV, Racz GB. Recurrence and spread of complex regional pain syndrome due to distant site surgery: a case report. Am J Orthop (Belle Mead NJ). 2006;35(11):523–6.Google Scholar
  56. 56.
    Stanton TR, Wand BM, et al. Local anesthetic sympathetic blockade for complex regional pain syndrome. Cochrane Database Syst Rev. 2013;(8):CD0004598.Google Scholar
  57. 57.
    Stanton-Hicks M, Baron R, Boa R, et al. Complex regional pain syndromes: guidelines for therapy. Clini J Pain. 1998;14:155–66.CrossRefGoogle Scholar
  58. 58.
    Sullivan MD. Who gets high dose opioid therapy for chronic non-cancer pain? Pain. 2010;151:567–8.CrossRefPubMedGoogle Scholar
  59. 59.
    Van de Vusse AC, Stomp-van den Berg SGM, Kessels AHF, Weber WEJ. Randomized controlled trial of gabapentin in complex regional pain syndrome type 1. BMC Neurol. 2004;4:13. doi: 10.1186/1471-4-13.CrossRefPubMedPubMedCentralGoogle Scholar
  60. 60.
    van Eijs F, Stanton-Hicks M, Van Zundert J, Faber CG, Lubenow TR, Mekhail N, van Kleef M, Huygen F. Evidence-based interventional pain medicine according to clinical diagnoses. 16. Complex regional pain syndrome. Pain Practice. 2011;11(1):70–87. Jan/Feb 2011.Google Scholar
  61. 61.
    van Eijs F, Geurts JW, Van Zundert J, Faber CG, Kessels AG, Joosten EA, van Kleef M. Spinal cord stimulation in complex regional pain syndrome type I of less than 12 month duration. Neuromodulation. 2012;15(2):144–50. March/April 2012.CrossRefPubMedGoogle Scholar
  62. 62.
    Varenna M, Zucchi F, Ghiringhelli D, et al. Intravenous clodronate in the treatment of reflex sympathetic dystrophy syndrome. J Rheumatol. 2000;27:1477–83.PubMedGoogle Scholar
  63. 63.
    Velasco F, Carrillo-Ruiz JD, Castro G, et al. Motor cortex stimulation applied to patients with complex regional pain syndrome. Pain. 2009;147:91–8.CrossRefPubMedGoogle Scholar
  64. 64.
    Verdugo RJ, Moya MF, Cea JG, Salinas HA, Bilbeny CJ. Stellate ganglion block in reflex sympathetic dystrophy: a double-blind crossover study. Program and abstracts of the 1st scientific meeting of the European Federation of IASP chapters, Verona: IASP; 1995.Google Scholar
  65. 65.
    Wang H, Kohno T, Amaya F, Brenner GJ, Ito N, Allchorne W. Bradykinin produces pain hypersensitivity by potentiating spinal cord glutaminergic synaptic transmission. J Neurosci. 2005;25:7986–92.CrossRefPubMedGoogle Scholar
  66. 66.
    Wassr G, Schattschneider J, Heckman K, Maier C, Baron R. Vascular abnormalities in reflex sympathetic dystrophy [CRPS1]: mechanisms and diagnostic value. Brain. 2001;124:587–99.CrossRefGoogle Scholar
  67. 67.
    Wilkinson HA. Percutaneous radiofrequency upper thoracic sympthectomy. Neurosurgery. 1996;38(4):715–25.CrossRefPubMedGoogle Scholar
  68. 68.
    Wong GY, Schroeder DR, Carns PE, Wilson JL, Martin DP, Kinney MO, Mantilla CB, Warner DO. Effect of neurolytic celiac plexus block on pain relief, quality of life, and survival in patients with unresectable pancreatic cancer: a randomized controlled trial. JAMA. 2004;291:1092–9.CrossRefPubMedGoogle Scholar
  69. 69.
    Yang IY, Oraee S, Viejo C, Stern H. Computed tomography celiac trunk topography relating to celiac plexus block. Reg Anesth Pain Med. 2011;36:21–5.CrossRefPubMedGoogle Scholar
  70. 70.
    Yarmohammadi H, Nakamoto DA, Azar N, Hayek SM, Haaga JR. Percutaneous computed tomography guided cryoablation of the celiac plexus as an alternative treatment for intractable pain caused by pancreatic cancer. J Cancer Res Ther. 2011;7(4):481–3.CrossRefPubMedGoogle Scholar
  71. 71.
    Zhang CL, Zhang TJ, Guo YN, Yang LQ, He MW, Shi JZ, Ni JX. Effect of neurolytic celiac plexus block guided by computerized tomography on pancreatic cancer pain. Dig Dis Sci. 2008;53(3):856–60.CrossRefPubMedGoogle Scholar
  72. 72.
    Zhong WA, Yu Z, Zeng J-X, Lin Y, Yu T, Min X-H, Yuan Y-H, Chen Q-K. Celiac plexus block for treatment of pain associated with pancreatic cancer: a meta-analysis. Pain Pract. 2014;14(1):43–5.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Octavio Calvillo
    • 1
  • Gabor B. Racz
    • 2
  • Carl Noe
    • 3
  1. 1.Department of AnesthesiologyMethodist Hospital HoustonHoustonUSA
  2. 2.Department of AnesthesiologyTexas Tech University Health Sciences CenterLubbockUSA
  3. 3.Department of Anesthesiology and Pain ManagementUniversity of Texas Southwestern Medical CenterDallasUSA

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