Is quality of life improved by neurolytic coeliac plexus block in pancreatic cancer pain management (original) (raw)
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Scholars journal of applied medical sciences, 2022
Original Research Article Introduction: Pancreatic cancer is a formidable health problem with increasing incidence. Worldwide, over 200000 people die annually of pancreatic cancer Because of high fatality rates; pancreatic cancer incidence rates are almost equal to mortality rates. Pancreatic cancer is diagnosed late in the natural history of the disease, giv en the few early indicators of illness, and the lack of screening tests for this disease. Neurolytic celiac plexus block (NCPB) is commonly used to treat pain of upper abdominal cancer that fails to respond to narcotic analgesics. CPB refers to the temporary inhibition of the celiac plexus often achieved with a corticosteroid injection in patients with benign pancreatic diseases like chronic pancreatitis. Aim of the study: The aim of this study was to determine and compare the adverse effect of analgesics and coeliac plexus block in relieving pain in carcinoma of pancreas. Methods: This study was a randomized comparative study and was conducted in the
EAS Journal of Anaesthesiology and Critical Care
Background: Pancreatic cancer is a formidable health problem worldwide with increasing incidence. Debilitating pain is very common in patients with pancreatic cancer. The aim of this study is to observe the effectiveness of neurolytic coeliac plexus block for the relief of pain due to carcinoma of pancreas. Methods: This randomized comparative study carried out in the Department of Anaesthasia, Analgesia and Intensive Care Medicine of Bangabandhu Sheikh Mujib Medical University, Dhaka with a period from July 2008 to June 2010 for two (2) years. Result: All patients of carcinoma pancreas >18 years of age with both sexes, who were needed palliation for their end stage carcinoma, were included in this study and were divided into two groups of which group A was taken the CPB and group B was taken the conventional treatment. A total number of 30 patients were enrolled in this study of which 15 were in the group A who were treated with the neurolytic celiac plexus block (NCPB) and 15 w...
Scholars Research Publisher , 2021
Original Research Article Background: Malignant pancreatic cancer has a high death rate, and it is difficult to treat because of the excruciating agony it causes. Opioids and adjuvants are commonly used to alleviate severe stomach pain. Objectives: CPB is a type of neural therapy treatment. Limited and inconsistent research has been done on the impact of QoL on patients. We hoped to find a solution to this problem with this investigation. Materials and Methods: Multicenter non-randomized quasi-experimental prospective study has been conducted in Rajshahi Medical College Hospital and tertiary care Hospital Rajshahi, Bangladesh. From January 2019 until July 2021.We studied a total of 16 patients with severe abdominal pain who had failed to react to combination systemic analgesic treatment or who had adverse effects that made it impossible to continue with the current dosage. A 35-day follow-up study looked at the effectiveness of CPB as a palliative analgesic. The VAS questionnaire was used to see if pain intensity could be altered as a primary result. The SF-36 questionnaire enhanced QoL secondary outcomes. We closely monitored the pain medications for any undesirable side effects. Results: Patients' VAS pain scores dropped significantly (P=0.002) after CPB, and their need for opiates dropped as well. When the extent of the impact is taken into consideration, their QoL scores also increased (P<0.001). During the research period, no side effects associated with CPB were found. There were also no negative medication responses. Conclusion: Our findings provide early evidence that CPB may be beneficial in individuals with advanced pancreatic cancer who are also receiving conventional pain medication. CPB appears to enhance QoL in these individuals at least 5 weeks after the Intervention, according to this research.
Celiac plexus block versus analgesics in pancreatic cancer pain
Pain, 1993
Twenty pancreatic cancer patients were studied to assess the effectiveness and duration of celiac plexus block compared to traditional treatment with analgesics by considering the previous and subsequent consumption of narcotics until their death. After 1 week of therapy with NSAID-narcotic sequence according to the WHO method, 10 patients were continued on this treatment, while the other 10 patients underwent celiac plexus block. Subsequently analgesics were administered as in the patients not treated by the block. A visual analogue score and opioid consumption were used to calculate the effective analgesic dose at weekly intervals until death. Celiac plexus block made pain control possible with a reduction in opioid consumption for a mean survival period of about 51 days. Administration of only analgesics resulted in an equal reduction in VAS pain score until death, but with more unpleasant side effects than when using celiac plexus block.
The Role of Neurolytic Celiac Plexus Block in the Treatment of Pancreatic Cancer Pain
Transplantation Proceedings, 2008
Pancreatic carcinoma, an important leading cause of cancer death, has increased steadily in incidence and still has a poor prognosis. Pain is one of the most frequent symptoms, affecting more than 75% of patients. It is often present in the early stages of disease and may be severe and difficult to treat. Abdominal viscera, including pancreas, liver, gallbladder, adrenal, kidney, and the gastrointestinal tract from the level of the gastroesophageal junction to the splenic flexure of the colon are innervated, at least in part, via the celiac plexus. Thus, painful tumors in these viscera may have pain relieved through the use of a neurolytic celiac plexus block (NCPB). Although some investigators questioned the role and the efficacy of NCPB in the treatment of upper abdominal cancer pain, most of them have suggested that it may represent the optimal treatment, especially for pancreatic cancer pain. In this report we have reviewed the techniques, results, and complications of NCPB for the treatment of pancreatic cancer pain.
Pain, 1996
Twenty-one patients with pancreatic cancer pain were studied to evaluate the effectiveness of celiac plexus block (CPB) on pain relief and quality of life (QOL), compared to the traditional NSAID-morphine treatment. The criteria were morphine consumption, visual analogue pain scale (VAS), performance status (PS) determined by medical and nursing staffs, and answers to QOL questionnaires. Morphine consumption, VAS, PS, and self-assessed QOL scores were taken when the administration of morphine was necessary for pain relief and those scores were used as control. Morphine consumption and the VAS score were recorded at regular weekly intervals and the PS and QOL scores were measured every 2 weeks thereafter. CPB was performed within 2-3 days after the control measurement. The VAS scores of the patients receiving CPB (n = 10) were statistically lower for the first 4 weeks after the procedure than those of the patients receiving the standard NSAID-morphine treatment (n = 11) during the sa...
British Journal of Surgery, 1998
Background In a randomized double-blind study the efficacy of neurolytic coeliac plexus block (NCPB) was compared with pharmacological therapy in the treatment of pain from pancreatic cancer. Methods Twenty-four patients were divided into two groups: 12 patients underwent NCPB (group 1) and 12 were treated with pharmacological therapy (group 2). Immediate and long-term efficacy, mean analgesic consumption, mortality and morbidity were evaluated at follow-up. Statistical analysis was performed with the unpaired t test, Mann-Whitney U test and Fisher's exact test. Results Immediately after the block, patients in group 1 reported significant pain relief compared with those in group 2 (P Ͻ 0·05), but long-term results did not differ between the groups. Mean analgesic consumption was lower in group 1. There were no deaths. Complications related to NCPB were transient diarrhoea and hypotension (P not significant between groups). Drug-related adverse effects were constipation (five of 12 patients in group 1 versus 12 of 12 in group 2), nausea and/or vomiting (four of 12 patients in group 1 versus 12 of 12 in group 2) (P Ͻ 0·05), one gastric ulcer and one gluteal abscess in group 2. Conclusion NCPB was associated with a reduction in analgesic drug administration and drug-related adverse effects, representing an effective tool in the treatment of pancreatic cancer pain.
SAS journal of surgery, 2022
Original Research Article Introduction: For both patients and their families, the most concerning aspect of cancer is pain. Neurolytic Coeliac Plexus Block can be used to relief the pain of the patients with pancreatic carcinoma. Aim of the Study: The aim of this study was to assess the outcome of neurolytic coeliac plexus block for the relief of pain due to carcinoma of pancreas. Methods: This cross-sectional study was conducted in Department of Anaesthesia, Bangabandhu Sheikh Mujib Medical College, Dhaka, Bangladesh, during the period from July 2008 to June 2010. Total 50 patients with carcinoma pancreas were included in this study. Result: In this study, in group A and B the mean ± SD pain in VAS before treatment are 8.80±0.86 & 8.07±1.44 respectively. At 1st, 2nd, 7th and 15th day of treatment the mean pain in VAS of group A & group B are (2.30± 0.98 & 5.53±0.99); (2.27 ± 0.70 & 5.60 ± 1.24); (2.13± 1.13 & 6.07±1.16) and (2.27 ± 1.39 &6.40 ± 0.74) respectively. Before starting the treatment, mild anorexia was found in 7(28%) & 8(32%) cases among group A & B. Moderate anorexia was found in 10(40%) cases and 7(28%) cases in group A and group B respectively. Severe anorexia was seen in 8(32%) cases and 10(40%) cases in group A and group B respectively. In 1st day of treatment mild anorexia was found in 9(36%) and 7(28%) cases in group A and group B respectively. Moderate anorexia was found in 8(32%) and 10(40%) cases in group A and group B respectively. Anorexia was found absent by 8(32%) in both groups. At 15th day of treatment, we found mild anorexia was present in 13(52%) & 2(8%); moderate anorexia was 8(32%) & 13(52%) in group A & B respectively. Severe anorexia was found in 10(40%) cases in group B and absent in group A. Anorexia was absent in 3(12%) cases in group A and 2(8%) in group B. In group A majority of patients had moderate vomiting 10(40%) & severe vomiting 8(32%) and in group B majority of them had severe vomiting 10(40%), mild vomiting 8(32%) before starting treatment. Before starting treatment, sleep disturbance was severe in 8(32%) & 10(40%) patients in group A & B respectively. After 15th day of treatment, we found severe sleep disturbance was 12% in group B on the other hand sleep disturbance was absent in 12% in group A respectively. Conclusion: There was statistically significant reduction of pain using Neurolytic Coeliac Plexus Block for Carcinoma of Pancreas. Adverse effects of NCPB were common but transient and mild and severe adverse effects are uncommon.
The Clinical Journal of Pain, 2013
Background: The efficacy of a celiac plexus block for the treatment of upper abdominal cancer-related pain has been documented. However, the effect of preprocedural pharmacological control of pain on its efficacy remains unknown. The researchers investigated the effect of first controlling severe pain with medications and then performing the celiac plexus block and compared the results with those obtained when the celiac block was performed first followed by pharmacotherapy for controlling severe pain; the impact on and duration of pain relief, effect on the quality of life, and analgesic requirements were analyzed.