Celiac Plexus Neurolysis for the Treatment of Patients with Terminal Cancer at a Tertiary University Hospital in Korea

Overview

Journal Hanguk Hosupisu Wanhwa Uiryo Hakhoe Chi

Date 2023 Jul 27

PMID 37496890

Authors

Gyeong-Jo Byeon

Juyeon Park

Yun-Mi Choi

Hyun-Su Ri

Ji-Uk Yoon

Eun-Ji Choi

Affiliations

Soon will be listed here.

Abstract

Purpose: The aim of this study was to investigate celiac plexus neurolysis (CPN) for the treatment of cancerous upper abdominal pain in a tertiary university hospital in Korea.

Methods: At the tertiary university hospital in Korea, electronic medical records of cancer patients who underwent CPN and died in the hospital from November 2009 to June 2018 were retrospectively analyzed.

Results: The total number of subjects was 51. The 17 patients were from the Department of Gastroenterology (33.0%), followed by 11 patients from the Department of Hemato-oncology (21.6%), 11 patients from the Department of Anesthesia and Pain Medicine (21.6%), 9 patients from the Department of General Surgery (17.6%). The diagnosis was pancreatic cancer in 15 patients (29.4%), stomach cancer in 8 patients (15.7%), hepatobiliary cancer in 20 patients (39.2%), colon cancer in 1 patient (2.0%), esophageal cancer in 2 patient (3.9%) and intra-abdominal metastasis in 5 patients (9.8%). The mean survival time after the surgery was 66.4±55.0 days. The pain intensity before and 1 week after the procedure significantly decreased, but the amounts of opioids consumed before and 1 week after the procedure were not statistically significant. Side effects occurred after the procedure including temporary localized pain in 24 patients (47.0%), hypotension in 12 (23.5%), and diarrhea in 6 (11.8%).

Conclusion: CPN is an effective and safe procedure for reducing upper abdominal pain caused by cancer, and it is necessary to perform CPN within the appropriate time by establishing a system of interdepartmental cooperation.

References

Erdine S . Celiac ganglion block. Agri. 2005; 17(1):14-22. View

Ina H, Kitoh T, Kobayashi M, Imai S, Ofusa Y, Goto H . New technique for the neurolytic celiac plexus block: the transintervertebral disc approach. Anesthesiology. 1996; 85(1):212-7. DOI: 10.1097/00000542-199607000-00028. View

Oh T, Lee W, Woo S, Kim N, Yim J, Kim D . Impact of Celiac Plexus Neurolysis on Survival in Patients with Unresectable Pancreatic Cancer: A Retrospective, Propensity Score Matching Analysis. Pain Physician. 2017; 20(3):E357-E365. View

Dobosz L, Stefaniak T, Dobrzycka M, Wieczorek J, Franczak P, Ptaszynska D . Invasive treatment of pain associated with pancreatic cancer on different levels of WHO analgesic ladder. BMC Surg. 2016; 16:20. PMC: 4836189. DOI: 10.1186/s12893-016-0136-3. View

de Oliveira R, dos Reis M, Prado W . The effects of early or late neurolytic sympathetic plexus block on the management of abdominal or pelvic cancer pain. Pain. 2004; 110(1-2):400-8. DOI: 10.1016/j.pain.2004.04.023. View

Fujii-Lau L, Bamlet W, Eldrige J, Chari S, Gleeson F, Abu Dayyeh B . Impact of celiac neurolysis on survival in patients with pancreatic cancer. Gastrointest Endosc. 2015; 82(1):46-56.e2. PMC: 6017988. DOI: 10.1016/j.gie.2014.12.036. View

Benyamin R, Trescot A, Datta S, Buenaventura R, Adlaka R, Sehgal N . Opioid complications and side effects. Pain Physician. 2008; 11(2 Suppl):S105-20. View

Nagels W, Pease N, Bekkering G, Cools F, Dobbels P . Celiac plexus neurolysis for abdominal cancer pain: a systematic review. Pain Med. 2013; 14(8):1140-63. DOI: 10.1111/pme.12176. View

Wong G, Schroeder D, Carns P, Wilson J, Martin D, O Kinney M . Effect of neurolytic celiac plexus block on pain relief, quality of life, and survival in patients with unresectable pancreatic cancer: a randomized controlled trial. JAMA. 2004; 291(9):1092-9. DOI: 10.1001/jama.291.9.1092. View

10.

Eisenberg E, Carr D, CHALMERS T . Neurolytic celiac plexus block for treatment of cancer pain: a meta-analysis. Anesth Analg. 1995; 80(2):290-5. DOI: 10.1097/00000539-199502000-00015. View

11.

Portenoy R . Treatment of cancer pain. Lancet. 2011; 377(9784):2236-47. DOI: 10.1016/S0140-6736(11)60236-5. View

12.

Bowles M, Benjamin I . ABC of the upper gastrointestinal tract: Cancer of the stomach and pancreas. BMJ. 2001; 323(7326):1413-6. PMC: 1121865. DOI: 10.1136/bmj.323.7326.1413. View

13.

Kong Y, Shin J, Leem J, Suh J . Computed Tomography (CT) Simulated Fluoroscopy-Guided Transdiscal Approach in Transcrural Celiac Plexus Block. Korean J Pain. 2013; 26(4):396-400. PMC: 3800714. DOI: 10.3344/kjp.2013.26.4.396. View

14.

Wang P, Shang M, Qian Z, Shao C, Wang J, Zhao X . CT-guided percutaneous neurolytic celiac plexus block technique. Abdom Imaging. 2006; 31(6):710-8. DOI: 10.1007/s00261-006-9153-5. View

15.

Berdine H, Nesbit S . Equianalgesic dosing of opioids. J Pain Palliat Care Pharmacother. 2006; 20(4):79-84. View

16.

Shaheen P, Walsh D, Lasheen W, Davis M, Lagman R . Opioid equianalgesic tables: are they all equally dangerous?. J Pain Symptom Manage. 2009; 38(3):409-17. DOI: 10.1016/j.jpainsymman.2009.06.004. View

17.

Koyyalagunta D, Engle M, Yu J, Feng L, Novy D . The Effectiveness of Alcohol Versus Phenol Based Splanchnic Nerve Neurolysis for the Treatment of Intra-Abdominal Cancer Pain. Pain Physician. 2016; 19(4):281-92. View

18.

Ferreira K, Kimura M, Teixeira M . The WHO analgesic ladder for cancer pain control, twenty years of use. How much pain relief does one get from using it?. Support Care Cancer. 2006; 14(11):1086-93. DOI: 10.1007/s00520-006-0086-x. View