Open AccessComputed tomography-guided celiac plexus neurolysis for intractable pain of unresectable pancreatic cancer
Author(s) -
Rania E. Mohamed,
Mohamed A. Amin,
Hazem Omar
Publication year - 2017
Publication title -
the egyptian journal of radiology and nuclear medicine /the egyptian journal of radiology and nuclear medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.19
H-Index - 13
eISSN - 2090-4762
pISSN - 0378-603X
DOI - 10.1016/j.ejrnm.2017.03.027
Subject(s) - medicine , neurolysis , pancreatic cancer , celiac plexus , cancer pain , analgesic , adverse effect , anesthesia , surgery , cancer , radiology
Aim of this study: To appraise the value of CT-guided celiac plexus neurolysis (CPN) as an effective method for alleviating intractable pain in patients with unresectable pancreatic cancer. Patients and methods: 22 patients (their ages ranged between 45 and 73Â years) with severe pain due to unresectable pancreatic cancer were subjected to CT-guided CPN by 25â30Â mL of 97% ethanol via anterior approach and single puncture technique. The pain intensity scoring, both before and after the procedure, was done using the Visual Analogue Scale (VAS). Results: All patients showed a significant pain reduction after CPN (PÂ <Â 0.001), with peak reduction in the first day after CPN. Also, the mean ranks of analgesic requirements showed significant reduction (PÂ <Â 0.001) and this reduction in analgesic requirements was maintained up to 3Â months after the CPN. Less than half of the study population (45.5%) had some post-procedural adverse events, which were minimal and transient. Conclusion: The CT-guided CPN via using anterior median approach and single puncture technique with injection of 25â30Â mL of 97% of ethanol is an ideal palliative treatment for controlling severe pain caused by unresectable pancreatic cancer, with a significant reduction in the analgesic requirements. Keywords: Celiac plexus, Pain, Intractable, Pancreatic carcinoma, Tomography, Compute