pISSN 2005-9159
eISSN 2093-0569

Clinical Research Article

Korean J Pain 2022; 35(2): 202-208

Published online April 1, 2022 https://doi.org/10.3344/kjp.2022.35.2.202

Copyright © The Korean Pain Society.

Splanchnic nerve neurolysis via the transdiscal approach under fluoroscopic guidance: a retrospective study

Zhenhua Cai1,2 , Xiaolin Zhou1 , Mengli Wang3 , Jiyu Kang1 , Mingshuo Zhang1 , Huacheng Zhou1

1Department of Pain Management, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
2Department of Pain Management, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
3Department of Anesthesiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China

Correspondence to:Huacheng Zhou
Department of Pain Management, The Fourth Affiliated Hospital of Harbin Medical University, No. 37, Yiyuan Street, Nangang District, Harbin 150001, Heilongjiang, China
Tel: +86-451-85939542
Fax: +86-451-85939730
E-mail: zhouhuacheng@163.com

Handling Editor: Jin Woo Shin

Received: October 14, 2021; Revised: December 18, 2021; Accepted: December 20, 2021

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background: Neurolytic celiac plexus block (NCPB) is a typical treatment for severe epigastric cancer pain, but the therapeutic effect is often affected by the variation of local anatomical structures induced by the tumor. Greater and lesser splanchnic nerve neurolysis (SNN) had similar effects to the NCPB, and was recently performed with a paravertebral approach under the image guidance, or with the transdiscal approach under the guidance of computed tomography. This study observed the feasibility and safety of SNN via a transdiscal approach under fluoroscopic guidance.
Methods: The follow-up records of 34 patients with epigastric cancer pain who underwent the splanchnic nerve block via the T11-12 transdiscal approach under fluoroscopic guidance were investigated retrospectively. The numerical rating scale (NRS), the patient satisfaction scale (PSS) and quality of life (QOL) of the patient, the dose of morphine consumed, and the occurrence and severity of adverse events were recorded preoperatively and 1 day, 1 week, 1 month, and 2 months after surgery.
Results: Compared with the preoperative scores, the NRS scores and daily morphine consumption decreased and the QOL and PSS scores increased at each postoperative time point (P < 0.001). No patients experienced serious complications.
Conclusions: SNN via the transdiscal approach under flouroscopic guidance was an effective, safe, and easy operation for epigastric cancer pain, with fewer complications.

Keywords: Abdominal Pain, Alcohols, Autonomic Nerve Block, Cancer Pain, Celiac Plexus, Neoplasms, Nerve Block, Neurolysis, Splanchnic Nerves.