title: [Efficacy of CT-guided splanchnic nerve block for persistent pain after fluoroscopy-guided nerve block in a patient with advanced pancreatic cancer].
abstract: We report a successful case of CT-guided splanchnic nerve block in a patient with advanced pancreatic cancer. A 76-year-old woman with epigastric distress was diagnosed with pancreatic cancer with multiple metastases. She underwent chemotherapy, but decided on best supportive care when her performance status worsened. Computed tomography revealed a 6 x 8 cm tumor mass in the pancreatic head. Oral oxycodone 20 mg x day(1) was ineffective and her Numerical Rating Scale (NRS) score was 9. Fluoroscopy-guided splanchnic nerve block with alcohol from L1-2 significantly reduced her pain, but she still required a fentanyl patch 2.1 mg x 3 days(-1) and loxoprofen (NRS 3). Four days later, we performed CT-guided splanchnic nerve block with alcohol 10 ml from T11-12. This significantly alleviated her pain and she was discharged uneventfully. She died 3 weeks after discharge. CT-guided splanchnic nerve block may be useful in cases of insufficient pain relief after fluoroscopy-guided splanchnic nerve block.
authors.affiliation: Department of Anesthesiology and Palliative Care Unit, Hyogo Cancer Center Akashi 673-8558.
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Komasawa
authors.affiliation: Department of Anesthesiology and Palliative Care Unit, Hyogo Cancer Center Akashi 673-8558.
authors.forename: Akio
authors.initials: A
authors.lastname: Hato
authors.affiliation: Department of Anesthesiology and Palliative Care Unit, Hyogo Cancer Center Akashi 673-8558.
authors.forename: Junichi
authors.initials: J
authors.lastname: Ikegaki
mesh_terms: D000368:Aged; D001340:Autonomic Nerve Block / Q000379:methods*; D017809:Fatal Outcome; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D010148:Intractable Pain / Q000628:therapy*; D010166:Palliative Care / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000150:complications*; D013153:Splanchnic Nerves; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome