Direct intraoperative versus percutaneous computed tomographyguided celiac plexus neurolysis in non-resectable pancreatic cancer: A randomized, controlled, non-inferiority study.

Abdelbaser, I ; Shams, T ; et al.

In: Revista espanola de anestesiologia y reanimacion, 2021-09-23

academicJournal

Background: Celiac plexus neurolysis (CPN) has been used to control pancreatic cancer (PC) pain, up to our knowledge, there is no study compared intraoperative CPN and computed tomography (CT)-guided techniques.

Objectives: To compare the effects of intraoperative and CT-guided CPN in unresectable PC on pain intensity and analgesic requirements.

Methods: A total of 90 patients were enrolled in this prospective, randomized, open label, controlled, non-inferiority study, 20 patients were excluded or lost to follow up. The patients were randomly allocated to either intraoperative or CT-guided CPN group. A mixture of 20ml ethanol 90%, 100mg lignocaine and 5mg dexamethasone was infused on each side of the aorta in both groups. Visual analogue score (VAS) and oral daily tramadol consumption were recorded at day 7, 14, 30, 60, 120 and 180 days after intervention. Occurrence of any intervention related complications were reported.

Results: Median VAS was similar in both intraoperative and CT-guided CPN groups from day 7 up to 180 days after intervention. The median daily analgesic consumption of oral tramadol (mg) was comparable in both intraoperative and CT-guided CPN groups after intervention at day 7 (50 versus 50), day14 (50 versus 50), day 30 (50 versus 50), day 60 (50 versus 50), day 120 (100 versus 75) and day 180 (100 versus 100). The incidence of diarrhea, vomiting, hypotension and back pain was similar in both groups.

Conclusion: Intraoperative CPN is non-inferior to CT-guided CPN as both techniques were similarly associated with reduced pain severity and analgesics requirements.

Titel:	Direct intraoperative versus percutaneous computed tomographyguided celiac plexus neurolysis in non-resectable pancreatic cancer: A randomized, controlled, non-inferiority study.
Autor/in / Beteiligte Person:	Abdelbaser, I ; Shams, T ; El-Giedy, AA ; Elsedieq, M ; Ghanem, MA
Zeitschrift:	Revista espanola de anestesiologia y reanimacion, 2021-09-23
Veröffentlichung:	Ahead of Print, 2021
Medientyp:	academicJournal
ISSN:	2341-1929 (electronic)
DOI:	10.1016/j.redar.2020.12.016
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Transliterated Title: Neurólisis del plexo celiaco intraoperatoria directa frente a percutánea guiada por tomografía computarizada en el cáncer de páncreas no operable: estudio aleatorizado, controlado y de no inferioridad. Publication Type: Journal Article Language: English; Spanish; Castilian [Rev Esp Anestesiol Reanim (Engl Ed)] 2021 Sep 23. <i>Date of Electronic Publication: </i>2021 Sep 23. Comments: Comment in: Rev Esp Anestesiol Reanim (Engl Ed). 2022 Feb;69(2):71-78. (PMID: 35183469) Contributed Indexing: Keywords: Celiac plexus; Computed tomography; Cáncer de páncreas; Intraoperative; Intraoperatorio; Neurolysis; Neurólisis; No resecable; Non-resectable; Pancreatic cancer; Plexo celiaco; Tomografía computarizada Entry Date(s): Date Created: 20210927 Latest Revision: 20240220 Update Code: 20240220

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