title: Comparison between celiac plexus block and morphine treatment on quality of life in patients with pancreatic cancer pain.
abstract: 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 same time period after the control measurement. Morphine consumption was significantly lower in weeks 4-7 (inclusive) following the procedure in the CPB group and continued to be lower thereafter, though not significantly so. Although the PS score slightly improved at the 2nd week after CPB, it was not improved by the start of the NSAID-morphine treatment. Self-assessed QOL scores did not ameliorate statistically after CPB; however, they did deteriorate remarkably in the patients treated only with morphine-NSAID during their survival periods, while they deteriorated only slightly in the CPB group. There were fewer side effects after CPB. These results indicate CPB does not directly improve QOL in patients with pancreatic cancer pain, but it may prevent deterioration in QOL by the long-lasting analgesic effect, limitation of side effects and the reduction of morphine consumption, compared to treatment only with NSAID-morphine.
authors.affiliation: Department of Anesthesia, Higashi Sapporo Hospital, 3-3-17, Higashi-Sapporo, Shiroishi-ku, Sapporo 003 Japan Department of Internal Medicine, Higashi Sapporo Hospital, 3-3-17, Higashi-Sapporo, Shiroishi-ku, Sapporo 003 Japan Institute of Palliative Care Medicine, Higashi Sapporo Hospital, 3-3-17, Higashi-Sapporo, Shiroishi-ku, Sapporo 003 Japan Department of Anesthesiology, Sapporo Medical University, School of Medicine, South-1, West-16, Chuo-ku, Sapporo 060 Japan.
authors.forename: Mikito
authors.initials: M
authors.lastname: Kawamata
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Ishitani
authors.forename: Kunitsugu
authors.initials: K
authors.lastname: Ishikawa
authors.forename: Hiromi
authors.initials: H
authors.lastname: Sasaki
authors.forename: Koichi
authors.initials: K
authors.lastname: Ota
authors.forename: Keiichi
authors.initials: K
authors.lastname: Omote
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Namiki
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002447:Celiac Plexus; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D009407:Nerve Block; D010146:Pain / Q000188:drug therapy / Q000523:psychology; D059408:Pain Management; D010147:Pain Measurement; D010190:Pancreatic Neoplasms / Q000150:complications*; D011788:Quality of Life; D011795:Surveys and Questionnaires
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004338:Drug Combinations; D009020:Morphine