ASGE Therapeutic EUS for Advanced Endosonographers (Live and Virtual) | September 2022-Celiac Plexus Block and Neurolysis

Video Transcription

Video Summary

This video transcript discusses celiac plexus blocks and neuralysis, which are medical procedures that aim to relieve pain in certain conditions. The speaker explains that celiac plexus blocks involve injecting an anesthetic, such as bupivacaine, into the area around the celiac plexus to mask pain. Neuralysis, on the other hand, involves injecting a substance like alcohol to destroy the nerves causing the pain. Different techniques can be used for these procedures, such as central injection, bilateral injection, or ganglia injection. The speaker cites various studies to support the use of these procedures in chronic pancreatitis and pancreatic cancer patients, but also highlights the potential risks and complications. The speaker recommends individualizing the treatment based on the patient's condition and preferences. They suggest offering the procedure to patients with chronic pancreatitis that haven't responded to other therapies, but caution that the response rates are about 50% and the relief is usually temporary. For pancreatic cancer patients, the speaker recommends using a single injection without neuralysis, especially for patients with potentially resectable disease. The speaker also stresses the importance of informed consent and discussing the potential risks and benefits with patients. Overall, celiac plexus blocks and neuralysis can be useful in managing pain, but careful consideration is needed for each individual patient's situation.

Asset Subtitle

John M. DeWitt, MD, FASGE

Keywords

celiac plexus blocks

neuralysis

pain relief

bupivacaine

alcohol injection

chronic pancreatitis

pancreatic cancer

informed consent