Arcidiacono, P.G., Calori, G., Carrara, S., McNicol, E.D., & Testoni, P. A. (2011). Celiac plexus block for pancreatic cancer pain in adults. Cochrane Database of Systematic Reviews (Online), 3, CD007519.
To assess the efficacy and safety of celiac plexus neurolysis in reducing pancreatic cancer pain; to identify adverse effects and differences associated with various techniques of celiac plexus neurolysis
The initial search retrieved 102 studies. Investigators reviewed the studies in terms of risk of bias. Investigators performed a meta-analysis on studies that they selected to include.
Celiac plexus block appears to be a safe and effective means of reducing bone pain associated with pancreatic cancer. Results show that celiac plexus block has a slight but statistically significant advantage over usual analgesic treatment. Investigators noted that the studies included in the analysis had some identified risk of bias. Three of the studies were blinded; three were not. The studies Arcidiacono et al. reviewed were the same studies that Yan and Myers reviewed in 2007.
Data are insufficient to allow researchers to evaluate the differences between CT-guided and posterior percutaneous celiac plexus block techniques.
Nurses should be aware of celiac plexus block as a means of pain management in patients with cancer of the pancreas. Nurses should advocate for the patient and inform him or her of potential treatment options. Findings of this meta-analysis are based on follow-up at four weeks, and results showed significant heterogeneity at eight weeks. This suggests that efficacy may not be sustainable over the long term. Further research, including long-term follow-up, is needed.