Prospective randomized double-blind trial of neurolytic coeliac plexus block in patients with pancreatic cancer.
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 < 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 < 0.05), one gastric ulcer and one gluteal abscess in group 2.


CONCLUSIONS
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.
Polati
E
E
Institute of Anaesthesiology and Intensive Care, University of Verona, Italy.
Finco
G
G
Gottin
L
L
Bassi
C
C
Pederzoli
P
P
Ischia
S
S
D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D001340:Autonomic Nerve Block / Q000379:methods*; D002447:Celiac Plexus; D004008:Diclofenac / Q000009:adverse effects / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000009:adverse effects / Q000627:therapeutic use; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D010190:Pancreatic Neoplasms; D011446:Prospective Studies; D012008:Recurrence
D000894:Anti-Inflammatory Agents, Non-Steroidal; D009294:Narcotics; D004008:Diclofenac