title: Effectiveness of Splanchnic Nerve Neurolysis for Targeting Location of Cancer Pain: Using the Pain Drawing as an Outcome Variable.
abstract: The effectiveness of splanchnic nerve neurolysis (SNN) for cancer-related abdominal pain 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 pain drawing score on 60 patients with pain from pancreatic or gastro-intestinal primary cancers or metastatic disease to the abdominal region. Results demonstrate excellent inter-rater agreement (intra-class correlation [ICC] coefficient at pre-SNN = 0.97 and ICC at within one month post-SNN = 0.98) for the grid method of scoring the pain drawing and demonstrate psychometric generalizability among patients with cancer-related pain. Using the Wilcoxon signed rank test and associated effect sizes, results show significant improvement in dispersion of pain following SNN. Effect sizes for the difference in pre-SNN to 2 post-SNN time points were higher for the pain drawing than for pain intensity rating. Specifically, the effect size difference from pre- to within one month post-SNN was r = 0.42 for pain drawing versus r = 0.23 for pain intensity rating. Based on a smaller subset of patients who were seen within 1 - 6 months following SNN, the effect size difference from pre-SNN was r = 0.46 for pain drawing versus r = 0.00 for pain intensity rating. Collectively, these data support the use of the pain drawing as a reliable outcome measure among patients with cancer pain for procedures such as SNN that target specific location and dispersion of pain.
authors.forename: Diane M
authors.initials: DM
authors.lastname: Novy
authors.forename: Mitchell P
authors.initials: MP
authors.lastname: Engle
authors.affiliation: UT MD Anderson Cancer Center, Houston, TX.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Lai
authors.affiliation: UT MD Anderson Cancer Center, Houston, TX.
authors.forename: Christina
authors.initials: C
authors.lastname: Cook
authors.affiliation: UT MD Anderson Cancer Center, Houston, TX.
authors.forename: Emily C
authors.initials: EC
authors.lastname: Martin
authors.affiliation: UT MD Anderson Cancer Center, Houston, TX.
authors.forename: Lisa
authors.initials: L
authors.lastname: Trahan
authors.affiliation: MD Anderson Cancer Center, Houston, TX.
authors.forename: Jun
authors.initials: J
authors.lastname: Yu
authors.forename: Dhanalakshmi
authors.initials: D
authors.lastname: Koyyalagunta
mesh_terms: D000328:Adult; D000368:Aged; D000072716:Cancer Pain; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010146:Pain; D010147:Pain Measurement; D013153:Splanchnic Nerves