Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Anesthesia and Pain Relief

A majority of pancreatic cancer patients present with pain at the time of diagnosis. Pain in pancreatic cancer may be visceral, somatic, or neuropathic in origin. Visceral nociceptive signals caused by damage to the upper abdominal viscera are carried along sympathetic fibers which travel to the celiac plexus nerves and ganglia which are found at the T12-L2 vertebral levels anterolateral to the aorta near the celiac trunk. From here the signals are transmitted through the splanchnic nerves to T5-T12 dorsal root ganglia, and on to the higher centers of the central nervous system. Apart from conventional pharmacotherapy, timely treatment with neurolytic celiac plexus block (NCPB) and or splanchnic nerves neurolysis has been shown to be of benefit. This prospective study was designed to compare the efficacy of combined splanchnic and transdiscal celiac neurolysis with the conventional celiac neurolysis for pain management of patients with pancreatic cancer

Issued also as CD