Abstract: Changes in Plasma Motilin and β-endorphin in Cancer Patients Treated with Neurolytic CeliacPlexus BlockPeng YAO1, Yuanyuan DING1, Changlin JIANG2, Jiaming MA1, Lingxin MENG1Correspondence to: Lingxin MENG, E-mail: menglx@sj-hospital.org1Department of Pain Control, Shengjing Hospital of China Medical University, Shenyang 110004, China2Daqing Oil Field General Hospital, Daqing 163001, ChinaAbstract Objective: To evaluate the effects of neurolytic celiac plexus block ( NCPB ) on pain relief, quality of life, and bloodconcentration of motilin and β-endorphin before and after treatment in patients with upper abdominal visceral cancer pain. Methods:Sixty-two patients with intractable upper abdominal visceral cancer pain were enrolled in the study ( 37 males and 25 females ). All cas-es, including those with pain managed by opioids and those who rejected opioid usage because of severe adverse effects, still sufferedpersistent moderate-to-severe pain ( NRS ≥5 ) and had poorer health-related quality of life. Patients with coagulation disorders, in-tra-abdominal infection, pyemia or intestinal obstruction were not included in this study. NCPB was performed under CT guidance. Nu-meric rating scales ( NRS ), pain relief and complications were recorded. Patients completed generic HS ( SF-36 ) and cancer-specificHRQL ( QOL-CS ) questionnaires before and after treatment to evaluate their quality of life. Blood concentration of motilin and β-en-dorphin was observed before treatment and 1, 3, and 7 days after NCPB. Results: Pain relief was observed in all patients after NCPB.Numeric rating scale ( NRS ) at day 7 after treatment was 1.1±0.3 on average, lower than that before treatment ( 7.6±1.2 ). Pain relief ≥50 % was achieved in 96.8 %. Some patients who experienced mild adverse effects including low blood pressure, diarrhea, nausea andvomiting needed to stop treatment. No severe complications were observed in this study. Higher scores were exhibited on all SF-36 andQOL-CS before NCPB and lower scores were seen after the NCPB. Blood concentrations of motilin and β-endorphin changed signifi-cantly after NCPB. Motilin level was increased on the first day after NCPB, peaked on day 3 and then slightly decreased on day 7. β-en-dorphin level was increased on day 3 and reached 336.9±29.4 pg/mL on day 7 after NCPB. Conclusion: NCPB under CT guidance isan effective and safe technique for controlling intractable upper abdominal cancer pain. This treatment increases blood concentrationlevels of motilin and β-endorphin and improves the quality of life of patients with cancer pain.Keywords Cancer pain; Neurolytic celiac plexus block (NCPB); Motilin; Endorphins; Quality of life