Neurolytic Coeliac Plexus Block Duration — FRCA Final MCQ

Instant feedback + full explanation. One question, done properly.

ModeratePain MedicineNeurolytic Coeliac Plexus Block DurationFRCA Final

A 48-year-old woman has intractable cancer pain from a pancreatic tail tumour. A neurolytic coeliac plexus block is planned using 50% alcohol. What is the expected duration of analgesia from a successful neurolytic block?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — 3-6 months

A neurolytic coeliac plexus block using alcohol (50-100%) or phenol (6-10%) typically provides analgesia for 3-6 months. The alcohol destroys the sympathetic nerve fibres by protein denaturation and extraction of lipids from the neural membrane. Over time, nerve regeneration may occur, allowing pain to return. The procedure can be repeated. Meta-analyses show good-to-excellent pain relief in 70-90% of patients with pancreatic cancer pain. Complications include: transient diarrhoea (sympatholysis), orthostatic hypotension, and rarely paraplegia (if the artery of Adamkiewicz is damaged).

Reference: Faculty of Pain Medicine – 2021 – Cancer pain interventional procedures; NICE – 2018 – NG85 Pancreatic cancer