Neurolytic celiac plexus block reduces occurrence and duration of terminal delirium in patients with pancreatic cancer

Abstract

The duration and occurrence of TD and the pain severity were significantly less in pancreatic cancer patients who underwent neurolytic CPB.

An integrative literature review exploring the clinical management of delirium in patients with advanced cancer

“…(). The CAM, DOS and MMSE were used in other studies (Arai et al., ; Gagnon et al., ; Tatematsu et al., ). The use of different tools means identification of delirium varied between the studies.…”

“…The findings of the research demonstrate that although there has been some investigation of the treatment of delirium in patients with advanced cancer, relatively few rigorous studies have been conducted. In terms of pharmacological interventions, the use of atypical antipsychotics reduced mean MDAS scores (Boettger & Breitbart, ; Breitbart et al., ), as did opioid rotation (Morita et al., and Moryl et al., ), a coeliac plexus block reduced the duration of terminal delirium (Arai et al., ), and methylphenidate was found to be effective in patients with hypoactive delirium (Gagnon et al., ). The one report of a nonpharmacological intervention found that the dose of antipsychotics could be reduced for patients participating in exercise therapy (Tatematsu et al., ).…”

“…Two studies reporting other pharmacological interventions were located. The first investigated the use of a coeliac plexus block (CPB), and it was found that the duration of terminal delirium (TD) was lower in the CPB group than the control group (1.8 ± 2.9 vs 10.4 ± 7.5 days respectively) (Arai et al., ). In the second, methylphenidate hydrochloride (Gagnon et al., ) was prescribed for patients with hypoactive delirium resulting in an improvement from 20.9 ± 4.9 pretreatment to 27.8 ± 2.4 on the MMSE when the patients were on a stable dose of methylphenidate (Gagnon et al., ).…”

“…The Japanese version, which omits some the original items, was used by Morita et al (2005). The CAM, DOS and MMSE were used in other studies (Arai et al, 2013;Gagnon et al, 2005;Tatematsu et al, 2001). The use of different tools means identification of delirium varied between the studies.…”

“…SUMMARY OF THE STUDIES INCLUDEDArai et al, 2013: This prospective study investigated terminal delirium in patients with pancreatic cancer and found that those who underwent a coeliac plexus block had terminal delirium for a shorter time than those who did not Boettger & Breitbart, 2011…”