A comparison of intraoperative celiac plexus block with pharmacological therapy as a treatment for pain of unresectable pancreatic cancer

Okuyama, Masaki; Shibata, Takashi; Morita, Tomoyo; Kitada, Masashi; Tukahara, Yasuo; Fukushima, Yukio; Ikeda, Kimimasa; Fuzita, Junya; Shimano, Takashi

doi:10.1007/s005340200042

Cited by 33 publications

(28 citation statements)

References 29 publications

(55 reference statements)

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“…Another randomized trial compared celiac block to medical pain management (non-steroidal anti-inflammatory drugs and opiates) and found a significant decrease in analgesic use (specifically opiates) in patients receiving chemical splanchnicectomy. 63 The mean age of this study was 67 years in the group receiving the block and 63 years in the pharmacologic group. In contrast, a similarly designed trial found no significant decrease in the use of opiates, no difference in quality of life, or difference in survival, although patients undergoing splanchnicectomy did score consistently lower on pain scores.…”

Section: Pain Managementmentioning

confidence: 96%

Pancreatic Cancer in the Very Elderly Patient: Challenges and Solutions

Bellevue¹,

Johnson²,

Feczko³

et al. 2016

Surg Res Open J

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Pancreatic cancer is responsible for a significant disease burden on the aging US population. The only chance at curing this highly morbid disease is surgical resection, however choosing appropriate surgical candidates in the elderly population remains challenging. We review the literature for appropriate treatment modalities to the elderly patient. Although significant literature exists in choosing appropriate surgical candidates as well as managing those not deemed fit for surgery, the medical community is not unified when approaching these patients. Further collaboration between the surgical, medical, and palliative communities will likely spawn better outcomes for less overall health care cost in the future.

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Section: Pain Managementmentioning

confidence: 96%

Pancreatic Cancer in the Very Elderly Patient: Challenges and Solutions

Bellevue¹,

Johnson²,

Feczko³

et al. 2016

Surg Res Open J

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“…While celiac plexus neurolysis is a currently accepted clinical treatment for severe intractable abdominal pain in abdominal malignancies and chronic pancreatitis, it is usually reserved for patients who have failed other treatment modalities. The reported year 1 success rate for pain relief is reportedly between 57-100%, depending on the approach and ethanol concentration (Okuyama et al, 2002;Vranken et al, 2002;Schmulewitz and Hawes, 2003;Klapman and Chang, 2005). Celiac plexus neurolysis requires surgical or anesthetic specialization and is usually performed at tertiary referral centers.…”

Section: Clinical Significancementioning

confidence: 99%

Gene Therapy Approach: HSV-Enkephalin Reduces Fibrosis, Inflammation, and Pain

Westlund¹

2012

Chronic Pancreatitis

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“…The reported first year success rate for pain relief is reported between 57 and 100%, based on the approach and ethanol concentration. [1][2][3][4] The effectiveness of blocks or sectioning of the sympathetic innervation, but not the vagus, indicates that afferent nerve fibers traveling with the sympathetic nerves are involved in transmitting nociceptive information from the pancreas. [5][6][7][8][9][10][11] Although generally well tolerated, reported complications after celiac plexus block include back pain, hypotension and diarrhea.…”

Section: Introductionmentioning

confidence: 99%