To Compare The Eus Guided Celiac Plexus Neurolysis With Opoids For Pancreatic Cancer Pain Relief And Quality Of Life. A Prospective Randomized Study From India

Aims EUS guided Celiac plexus neurolysis (CPN) and opoids are commonly used for pancreatic cancer related pain. The aim of this study was to compare the EUS –CPN versus opoid (tapendalol and pentazocine) in controlling the pancreatic cancer related pain and improving quality of life (QOL).

Methods This randomized control study involved matched 68 metastatic pancreatic cancer patients having significant pain. They were randomized equally into two groups to underwent EUS-CPN or to take opoids (tapendalol and pantozocine) for pain relief. EUS-CPN was successfully performed by a single experenced endosonographer. The injectate was delivered on both sides of the superior mesenteric artery origin. 15 to 20 mL of a mixture of 5 % iopamidol and 95 % of ethanol was also injected after injecting 2 to 3 ml of bupivacaine.

Pain scores and quality of life (QOL) were compared between the two groups. The primary endpoint was defined as the reduction in pain on visual analog scale (VAS) rated from a 0 to 10, every 4 weeks after the baseline for 6 months.

Results VAS scores decreased in both the groups but with decrease was more with EUS CPN group than opoid group at week 4, 12 and 16 (4.3 ± 2.1 for the EUS-CPN group vs 1.5 ± 1.1 for the control group (P = .03). Also the QOL between the groups were significantly better in EUS CPN group than opoid group till week 16. However, beyond week 16 till 24 week, both the groups behaved same. However, beyond 24 weeks, the drugs group (VAS =4.2 ± 1.2) fared better than EUS-CPN group (VAS=6.9 ± 1.2) p = 0.04.

Conclusions EUS-CPN is better than opids for controlling pancreatic cancer–associated pain till 16 weeks only. The EUS-PCN procedure should be repeated at 16 weeks.

Citation Raina H. eP411 TO COMPARE THE EUS GUIDED CELIAC PLEXUS NEUROLYSIS WITH OPOIDS FOR PANCREATIC CANCER PAIN RELIEF AND QUALITY OF LIFE. A PROSPECTIVE RANDOMIZED STUDY FROM INDIA. Endoscopy 2021; 53: S231.

Publication History

Article published online:
19 March 2021