Single needle versus double needle celiac trunk neurolysis in abdominal malignancy pain management: a randomized controlled trial

Abdelghaffar, Nevert A.; El-Rahmawy, Ghada Fathy; Elmaddawy, Alaa Eldin Adel; El‐Badrawy, Adel

doi:10.1016/j.bjane.2019.01.001

Cited by 6 publications

(10 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Three RCTs were done with CT guidance generating superior quality of evidence for this modality. The single-vs. double-needle approach was compared in one showing the single-needle approach to be equally efficacious (24). A second important study showed that the addition of superior hypogastric block to CPB may be of additional benefit in patients with upper abdominal malignancies (25).…”

Section: Resultsmentioning

confidence: 99%

Celiac Plexus Block – An Old Technique with New Developments

2021

Pain Phys

View full text Add to dashboard Cite

BACKGROUND: Celiac plexus block (CPB) is an interventional technique known to be effective in the management of abdominal pain caused by pancreatic cancer. OBJECTIVE: To review the journey of CPB as an interventional analgesic technique from its inception to its current status in the field of cancer pain management. STUDY DESIGN: Descriptive review. METHODS: PubMed database was searched for celiac plexus block, celiac plexus neurolysis, and pancreatic cancer pain relief. Randomized control trials and case series with more than 10 patients were included. A second search was done from the references of all the included articles to add studies fulfilling the inclusion criteria which were missed in the first broad search. RESULTS: A total of 44 studies were included in this literature review. Available evidence through the years was categorized based on the imaging technique used to guide needle insertion and studies were tabulated based on study design, the number of patients included, the technique of CPB, and the conclusions drawn. LIMITATIONS: Meta-analysis of the available studies was not done because of heterogeneous nature of studies. CONCLUSION: Over the years, the majority of clinical trials have focused on fluoroscopy-guided CPB. Computed tomography-guided blockade of celiac plexus is the next choice among pain physicians and percutaneous ultrasound-guided CPB is a relatively new technique. The data generated over the years does not point to a single technique being the gold standard for CPB and choice of technique may be guided by the individual’s preference, familiarity with the technique, and institutional practice. KEY WORDS: Pancreatic cancer, coeliac plexus block, coeliac plexus neurolysis

show abstract

Section: Resultsmentioning

confidence: 99%

Celiac Plexus Block – An Old Technique with New Developments

2021

Pain Phys

View full text Add to dashboard Cite

show abstract

“…Second, it can be completed with a single needle puncture. Requirement of fewer punctures may reduce the associated complications and the time required to perform the procedure [ 15 , 18 ], thereby reducing patient burden. Third, anatomically, it is less likely to cause organ or nerve damage than the anterior approach or paravertebral approach [ 12 , 13 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Neurolytic Splanchnic Nerve Block via Transintervertebral Disc Approach to Retrocrural Space: A Multicenter Retrospective Study

Yanaizumi

Nagamine²,

Harada³

et al. 2022

Pain Ther

View full text Add to dashboard Cite

Introduction Celiac plexus block is effective for treating intractable cancer pain and has been the focus of many studies. Several guiding techniques such as fluoroscopy, computed tomography, and endoscopy have been devised, and the target of the block has varied in previous studies as both the celiac plexus and splanchnic nerve, which is the main origin of the celiac plexus, have been targeted. At our affiliated institution, fluoroscopy-guided splanchnic nerve block with a single needle via transintervertebral disc approach is the first choice. However, there have been few reports on the use of this technique. This study investigated the efficacy and safety of this technique. Methods This multicenter retrospective observational study reviewed the medical records of patients who underwent neurolytic splanchnic nerve block (NSNB) via transintervertebral disc approach for intractable cancer pain at five tertiary hospitals in Japan from April 2005 to October 2020. The primary outcome was the clinical success ratio of NSNB, and the secondary outcome was the incidence ratio of NSNB-related adverse events. Results In total, 103 patients were included in the analysis. Of these, 77 patients met the definition of clinical success, with a ratio of 74.8%. The incidence ratio of NSNB-related adverse events was 40.8% (hypotension, 21.4%; alcohol intoxication, 13.6%; diarrhea, 11.7%; and vascular puncture, 3.9%; duplicates were present). All adverse events improved with observation and symptomatic treatment only. No patient had infection or serious adverse events such as organ or nerve damage. Conclusions The clinical success ratio of this technique was 74.8%. Although the incidence of adverse events was 40.8%, all events were mild and no serious adverse events were observed. The findings demonstrate the efficacy and safety of our NSNB in patients with intractable cancer pain.

show abstract

“…There are several lines of treatment such as surgical, pharmacological and neurolytic blocks [ 8 ]. Although opioids stay the cornerstone of cancer pain management, they produce many harmful side effects with negative impacts on the patient’s life [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Fluoroscopic anterior approach versus ultrasound guided superior hypogastric plexus neurolysis in cancer pelvic pain: a randomized controlled study

Abdelghaffar

Farahat

2022

BMC Anesthesiol

View full text Add to dashboard Cite

Background Cancer-related pelvic pain can be difficult and debilitating to treat. Superior hypogastric plexus neurolysis (SHPN) is a good choice for adequate pain relief with fewer side effects. The current study compared between fluoroscopic anterior approach and ultrasound guided SHPN in the management of cancer-related pelvic pain. Methods Patients were randomly allocated into two equal groups. The ultrasound group (US group) (n = 48) received SHPN by an ultrasound-guided anterior approach using 3 ml 5% bupivacaine plus 20 ml 10% phenol, while the fluoroscopy group (n = 48) received SHPN by a fluoroscopy-guided anterior approach using 3 ml 5% bupivacaine plus 20 ml 10% phenol. Results The time of the procedure was shorter in the fluoroscopic group (21.31 ± 4.79 min) than the US group (24.88 ± 6.02 min) (P = 0.002). Patient satisfaction was higher in the fluoroscopy group (5.38 ± 1.482) than the US group (2.98 ± 1.495) (P˂0.001). The need for analgesia using morphine was significantly limited in each group, at 1, 2 and 3 months intervals (P1˂0.001, P2 ˂0.001 and P3 ˂0.001). There were statistically significant differences between both groups regarding fatigue at baseline, drowsiness at 3 months, nausea and vomiting at 1, 2 and 3 months and anorexia at 3 months. Group comparison also revealed statistically significant differences regarding depression at one month, anxiety at 2 and 3 months and insomnia at baseline. Conclusion The fluoroscopic anterior approach SHPN was more superior than the US guided SHPN regarding the time of the procedure and patient satisfaction, while both technique were similar regarding the numeric rating scale and the complications during block. Trial registration Registered in the ClinicalTrials.gov (Identifier: NCT05299047) at 28/03/2022.

show abstract

Single needle versus double needle celiac trunk neurolysis in abdominal malignancy pain management: a randomized controlled trial

Cited by 6 publications

References 17 publications

Celiac Plexus Block – An Old Technique with New Developments

Celiac Plexus Block – An Old Technique with New Developments

Efficacy and Safety of Neurolytic Splanchnic Nerve Block via Transintervertebral Disc Approach to Retrocrural Space: A Multicenter Retrospective Study

Fluoroscopic anterior approach versus ultrasound guided superior hypogastric plexus neurolysis in cancer pelvic pain: a randomized controlled study

Contact Info

Product

Resources

About