Epidural fentanyl as an adjunct to coeliac plexus block

Coeliac plexus block is an effective and accepted therapeutic intervention for pain due to upper abdominal malignancy. Accurate placement of needles is contingent on the ability of patients to maintain immobility, usually prone, during performance of the block. Postural pain is a cardinal feature of abdominal neoplastic pain and may interfere with positioning for diagnostic and therapeutic procedures, including coeliac block. The use of epidural fentanyl analgesia as an aid to achieving comfort and immobility during coeliac block is described, along with its rationale and alternatives.