Open AccessEffectiveness of Splanchnic Nerve Neurolysis for Targeting Location of Cancer Pain: Using the Pain Drawing as an Outcome Variable
Author(s) -
Diane M. Novy,
Mitchell P. Engle,
Emily Lai,
Christina Cook,
Emily C. Martin,
Lisa H. Trahan,
Jun Yu,
Dhanalakshmi Koyyalagunta
Publication year - 2016
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj/2016.19.397
Subject(s) - medicine , cancer pain , neurolysis , wilcoxon signed rank test , generalizability theory , abdominal pain , physical therapy , anesthesia , surgery , cancer , mann–whitney u test , statistics , mathematics
The effectiveness of splanchnic nerve neurolysis (SNN) for cancer-related abdominalpain has been investigated using numeric pain intensity rating as an outcome variable.The outcome variable in this study used the grid method for obtaining a targeted paindrawing score on 60 patients with pain from pancreatic or gastro-intestinal primarycancers or metastatic disease to the abdominal region. Results demonstrate excellentinter-rater agreement (intra-class correlation [ICC] coefficient at pre-SNN = 0.97 andICC at within one month post-SNN = 0.98) for the grid method of scoring the paindrawing and demonstrate psychometric generalizability among patients with cancerrelated pain. Using the Wilcoxon signed rank test and associated effect sizes, resultsshow significant improvement in dispersion of pain following SNN. Effect sizes for thedifference in pre-SNN to 2 post-SNN time points were higher for the pain drawingthan for pain intensity rating. Specifically, the effect size difference from pre- to withinone month post-SNN was r = 0.42 for pain drawing versus r = 0.23 for pain intensityrating. Based on a smaller subset of patients who were seen within 1 – 6 monthsfollowing SNN, the effect size difference from pre-SNN was r = 0.46 for pain drawingversus r = 0.00 for pain intensity rating. Collectively, these data support the use ofthe pain drawing as a reliable outcome measure among patients with cancer pain forprocedures such as SNN that target specific location and dispersion of pain.Key words: Cancer pain, pain drawing, splanchnic block