Pain: coeliac plexus neurolysis: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Pain: coeliac plexus neurolysis

Sample item

A patient with pancreatic cancer receives a coeliac plexus neurolysis for severe upper abdominal pain. Which adverse effects are commonly expected?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Orthostatic hypotension and diarrhoea from sympathetic blockade

Neurolysis of the coeliac plexus blocks the splanchnic sympathetic supply to the upper abdominal viscera, leaving vagal tone unopposed. This causes vasodilation with orthostatic hypotension and increased gut motility with diarrhoea. Rare but serious complications include paraplegia from spinal cord ischaemia.

Option by option

  • A. Hypertension and constipation

    Hypertension and constipation are the opposite of the expected effects.

  • B. Orthostatic hypotension and diarrhoea from sympathetic blockade (correct)

    Correct. Sympathetic block causes hypotension and diarrhoea.

  • C. Urinary retention and leg weakness

    Leg weakness and retention are not the usual effects, although paraplegia is a rare complication.

  • D. Bradycardia and miosis

    Bradycardia and miosis suggest stellate ganglion block.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, Orthostatic hypotension and diarrhoea from sympathetic blockade. Neurolysis of the coeliac plexus blocks the splanchnic sympathetic supply to the upper abdominal viscera, leaving vagal tone unopposed.

Why is "Hypertension and constipation" not the answer?

Hypertension and constipation are the opposite of the expected effects.

Why is "Urinary retention and leg weakness" not the answer?

Leg weakness and retention are not the usual effects, although paraplegia is a rare complication.

Why is "Bradycardia and miosis" not the answer?

Bradycardia and miosis suggest stellate ganglion block.

What concept does this question test?

It tests Pain: coeliac plexus neurolysis in Anaesthesia. This causes vasodilation with orthostatic hypotension and increased gut motility with diarrhoea. Rare but serious complications include paraplegia from spinal cord ischaemia.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Pain: coeliac plexus neurolysis?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.