A comparison of intraoperative celiac plexus block with pharmacological therapy as a treatment for pain of unresectable pancreatic cancer.
OBJECTIVE
The efficacy of intraoperative celiac plexus block was compared with that of pharmacological therapy in the treatment of pain caused by unresectable pancreatic cancer.


METHODS
Twenty-one patients were included in the study: 15 patients underwent intraoperative celiac plexus block (group 1) and 6 received pharmacological therapy (group 2). The effectiveness at 1 week after treatment and from treatment to death was evaluated at follow-up by looking at mean analgesic consumption, mortality and morbidity, and any postoperative complications. Statistical analysis was performed using unpaired t-tests.


RESULTS
One week after the operation, the analgesic consumption of 14 patients in group 1 was the same as that before treatment, and 1 patient's consumption had decreased. Pain in 4 patients in group 2 did not change, but in 2 patients it increased. Mean opioid consumption was significantly lower in group 1. Complications related to the block were transient diarrhea and hypotension ( P not significant between groups). There was no operative mortality or major complication related to the block. The incidence of adverse drug-related effects, such as constipation, nausea, and vomiting, was significantly lower in group 1 than in group 2.


CONCLUSIONS
Intraoperative celiac plexus block made pain control possible with reduced opioid consumption, representing an effective, safe, and simple tool for the treatment of pain caused by unresectable pancreatic cancer.
D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001340:Autonomic Nerve Block; D002447:Celiac Plexus; D004008:Diclofenac / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy*; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000601:surgery; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac