Gut Check on Gastroenterology Archive

I had always assumed EUS-directed celiac plexus blocks, if they worked, were the best therapy for pancreatic cancer pain. However, when speaking recently with one of my pain clinic colleagues, he indicated that splanchnic nerve blocks also work pretty well in these patients.

The literature supports both approaches, but I was somewhat surprised that the evidence for splanchnic blocks possibly was superior.

So here is what I would like to ask you:

1) When you refer a patient (or have a patient) with pancreatic cancer pain, do you:

a) do an EUS guided celiac block or refer to the pain clinic for a splanchnic block?

b) discuss the options of celiac versus splanchnic nerve blocks?

2) What do you think is the best way to treat pancreatic cancer pain?

3) Were you even aware that splanchnic blocks for pancreatic pain were available?

I look forward to hearing from you on this subject!