Sympathetic Neural Blockade in the Evaluation and Treatment of Pain
Mark V. Boswell, B. Eliot Cole in Weiner's Pain Management, 2005
Postganglionic fibers radiate from the celiac ganglia to follow the course of the blood vessels to innervate the abdominal viscera. These organs include much of the distal esophagus, stomach, duodenum, small intestine, ascending and proximal transverse colon, adrenal glands, pancreas, spleen, liver, and biliary system. It is these postganglionic fibers, the fibers arising from the preganglionic splanchnic nerves, and the celiac ganglion that make up the celiac plexus. The diaphragm separates the thorax from the abdominal cavity while still permitting the passage of the thoracoabdominal structures, including the aorta, vena cava, and splanchnic nerves. The diaphragmatic crura are bilateral structures that arise from the anterolateral surfaces of the upper two or three lumbar vertebrae and discs. The crura of the diaphragm serve as a barrier to effectively separate the splanchnic nerves from the celiac ganglia and plexus below.
Neurolytic blocks
Harald Breivik, William I Campbell, Michael K Nicholas in Clinical Pain Management, 2008
The celiac plexus is constructed of loose nerve fibers forming a ganglion of 4 × 3 cm, which lies between the two celiac ganglia, on either side of the aorta at the level of the T12 and L1 vertebral bodies. The inferior vena cava lies anterior and to the right side of the celiac plexus. Although 90 percent of patients with cancer pain may obtain moderate to good pain relief from oral or parenteral medications, some will require interventional techniques to control their pain.22 Neurolysis of the sympathetic axis has been shown to be an effective and safe approach to manage visceral pain in such patients.23 These procedures require fluoroscopy to demonstrate the level of needle insertion and the use of contrast media helps prevent injection into major vessels or organs.24 Although ultrasonic guidance has been described for celiac plexus block,25 most procedures are carried out using x-ray or computed tomography (CT).
Gastroparesis
John F. Pohl, Christopher Jolley, Daniel Gelfond in Pediatric Gastroenterology, 2014
In addition to the intrinsic enteric nervous system (myenteric and submucosal plexuses), the stomach also receives innervation from the vagus nerve (parasympathetic) and the celiac ganglia (sympathetic). The vagus regulates fundic accommodation, antral contractions, and pyloric relaxation while the sympathetic input counters or inhibits these motor activities. The repertoire of neurotransmitters and signaling molecules in the stomach, both excitatory and inhibitory, are very similar to that found in the brain. The interstitial cells of Cajal (ICC), also known as ‘pacemaker cells’, constitute a unique group of cells (several subtypes) that are embedded within the wall of the stomach in close proximity to the enteric nerves. The ICC generate electrical slow waves that are eventually coupled to a smooth muscle contraction. Peristaltic contractions (3 cycles per minute) are initiated in the ‘pacemaker region’ in the proximal gastric body on the greater curvature and propagate distally to the antrum.
Spinal cord involvement in Lewy body-related α-synucleinopathies
Published in The Journal of Spinal Cord Medicine, 2020
Raffaele Nardone, Yvonne Höller, Francesco Brigo, Viviana Versace, Luca Sebastianelli, Cristina Florea, Kerstin Schwenker, Stefan Golaszewski, Leopold Saltuari, Eugen Trinka
Fibers originating in the rostroventral nucleus of the medulla that traveling in the Th/IML provide the efferent innervation. Of great importance is also the capacitance of the splanchnic-mesenteric bed. This region is supplied by the splanchnic nerve with cell bodies at the thoracic level and synapses at the celiac ganglion.91 Orthostatic hypotension is a chief complaint in the pure autonomic failure, in LBD and in MSA. Some cases starting as isolated autonomic failure and subsequently developing PD or LBD features were described.71,92,93 Moreover, dysfunctions of cardiac sympathetic and parasympathetic neurons were observed in the initial stages of PD.93 Even is also the genesis of orthostatic hypotension is likely to be multifactorial, the pathology of the dorsal motor nucleus of the vagus may explain the early occurrence of orthostatic hypotension.
A review on the efficacy and safety of iodine-125 seed implantation in unresectable pancreatic cancers
Published in International Journal of Radiation Biology, 2020
Sheng-Nan Jia, Fu-Xing Wen, Ting-Ting Gong, Xin Li, Hui-Jie Wang, Ya-Min Sun, Ze-Cheng Yang
The employment of implantation of radioactive material in the pancreatic cancer dates back to 1934 as Handley described the effectiveness of implantation of a radium needle in increasing the life span of 7 pancreatic cancer patients (Handley 1934). D'Angio et al were the first scientists who reported the efficacy of 125I implantation in unresectable cancer of the pancreas. These scientists implanted 125I in 19 patients during the period of 1954–1964 and suggested that it is an effective treatment to relieve pain and increase the life span of patients with local unresectable pancreatic tumors (D'Angio et al. 1970). Hilaris and Rousiss employed radioactive 125I seed implantation for the treatment of pancreatic cancers in ninety-eight patients, with an average survival time of 7 months (Hilaris and Rousiss 1975). Later on, various other scientists also employed this seed implantation technique in pancreatic cancer patients. Wang et al showed that implantation of 125I around the celiac ganglia in 23 patients with unresectable pancreatic cancer led to significant reduction of pain after about two weeks of implantation with no significant complication (Wang et al. 2012). Liu et al described that percutaneous, CT-guided 125I seeds implantation led to complete (8/26) to partial (9/26) response with an overall response rate as 65.38%. The authors also reported that the local control rate was about 88.46% and the median survival was 15.3 months (Liu et al. 2015).
Superior mesenteric ganglion via ovarian plexus nerve involved in the cross-talk between noradrenaline and GnRH in rat ovaries
Published in Systems Biology in Reproductive Medicine, 2023
María Belén Delsouc, Sandra Vallcaneras, Cristina Daneri Becerra, Fabián Heber Mohamed, Marina Fernández, Adriana Soledad Vega Orozco, Marilina Casais
It should be noted that noradrenergic stimulation of the ganglion increased ovarian GnRH levels only at 60 min. This effect of NA on GnRH was more significant and was maintained throughout the incubation period when the adrenergic drug was added directly to the incubation medium of the ovaries. Our results support those reported by Herbison (1997), who found an important role of NA in increasing the expression and secretion of the Gnrh mRNA necessary to drive follicle development. Therefore, we interpret that the tendency to normalization of GnRH levels in the ovary of the ex vivo system is due to the influence of this sympathetic pathway in an attempt to modulate the effects of noradrenergic stimulation in the gonad and, consequently, on cell death. Similarly, Bronzi et al. (2015) demonstrated the importance of the celiac ganglion-SON sympathetic pathway to regulate cell death in the rat ovary, which seems to prevail when GnRH levels increase above basal levels during the diestrus II stage.
Related Knowledge Centers
- Autonomic Nervous System
- Gastrointestinal Tract
- Lymph Node
- Abdomen
- Sympathetic Nervous System
- Ganglion
- Nerve
- Crus of Diaphragm
- Thoracic Diaphragm
- Adrenal Gland