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CC BY-NC-ND 4.0 · South Asian J Cancer 2016; 05(04): 204-209
DOI: 10.4103/2278-330X.195346
CANCER SURGERY : Original Article

Comparative evaluation of different volumes of 70% alcohol in celiac plexus block for upper abdominal malignsancies

Archana Dolly
Department of Anesthesiology, King George Medical University, Lucknow, Uttar Pradesh
,
Sarita Singh
Department of Anesthesiology, King George Medical University, Lucknow, Uttar Pradesh
,
Ravi Prakash
Department of Anesthesiology, King George Medical University, Lucknow, Uttar Pradesh
,
Jaishri Bogra
Department of Anesthesiology, King George Medical University, Lucknow, Uttar Pradesh
,
Anita Malik
Department of Anesthesiology, King George Medical University, Lucknow, Uttar Pradesh
,
Vinita Singh
Department of Anesthesiology, King George Medical University, Lucknow, Uttar Pradesh
› Author Affiliations Financial support and sponsorship: Nil.
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Abstract

Context: Celiac plexus block (CPB) (is an effective way to reduce cancer-associated pain in upper abdominal malignancies. Aims: To evaluate the efficacy and safety of different volumes of 70% alcohol in CPB. Settings and Design: Prospective, randomized, controlled clinical study. Subjects and Methods: Thirty patients of carcinoma gall bladder were randomly divided into three groups (n = 10) to receive 20, 30, and 40 ml of 70% alcohol in CPB. Statistical Analysis Used: All the continuous data were assessed analysis of variance followed by post-hoc tests (Tukey′s Honestly Significant Difference test). Ordinal data were compared using Kruskal-Wallis H-test followed by Mann-Whitney U-test. Categorical comparisons were performed using Chi-square test. Results: A significant difference in visual analog scale (VAS) score of Group I, Group I and Group III was observed from week 6 onward until the end of the study. At all these time intervals, VAS scores in Group I was higher than both Groups II and III during this time interval. VAS scores in Group III were significantly lower as compared to Group II from week 10 onward until the end of the study. As compared to baseline, at all the follow-up intervals, mean morphine requirement was significantly lower in Group II and Group III. A quality of life (QOL) score of Group III were higher as compared to Group I. Between Group II and Group III, significant difference was observed at week 16 only when Group III had a higher score as compared to Group II. Conclusions: VAS score, QOL, and reduction in morphine consumption were increased on increasing the volume of alcohol in CPB, 40 ml being most effective.

Key words

Alcohol - celiac plexus - lignocaine - malignancy - neurolysis - pain - transdiscal


Publication History

Article published online:
28 December 2020

© 2016. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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  • References

  • 1 Staats PS, Hekmat H, Sauter P, Lillemoe K. The effects of alcohol celiac plexus block, pain, and mood on longevity in patients with unresectable pancreatic cancer: A double-blind, randomized, placebo-controlled study. Pain Med 2001;2:28-34.
  • 2 Wong GY, Schroeder DR, Carns PE, Wilson JL, Martin DP, Kinney MO, et al. Effect of neurolytic celiac plexus block on pain relief, quality of life, and survival in patients with unresectable pancreatic cancer: A randomized controlled trial. JAMA 2004;291:1092-9.
  • 3 De Oliveira R, dos Reis MP, Prado WA. The effects of early or late neurolytic sympathetic plexus block on the management of abdominal or pelvic cancer pain. Pain 2004;110:400-8.
  • 4 Eisenberg E, Carr DB, Chalmers TC. Neurolytic celiac plexus block for treatment of cancer pain: A meta-analysis. Anesth Analg 1995;80:290-5.
  • 5 Markman JD, Philip A. Interventional approaches to pain management. Med Clin North Am 2007;91:271-86.
  • 6 Kaufman M, Singh G, Das S, Concha-Parra R, Erber J, Micames C, et al. Efficacy of endoscopic ultrasound-guided celiac plexus block and celiac plexus neurolysis for managing abdominal pain associated with chronic pancreatitis and pancreatic cancer. J Clin Gastroenterol 2010;44:127-34.
  • 7 De Cicco M, Matovic M, Balestreri L, Fracasso A, Morassut S, Testa V. Single-needle celiac plexus block: Is needle tip position critical in patients with no regional anatomic distortions? Anesthesiology 1997;87:1301-8.
  • 8 Wang ZJ, Webb EM, Westphalen AC, Coakley FV, Yeh BM. Multi-detector row computed tomographic appearance of celiac ganglia. J Comput Assist Tomogr 2010;34:343-7.
  • 9 Rykowski JJ, Hilgier M. Efficacy of neurolytic celiac plexus block in varying locations of pancreatic cancer: Influence on pain relief. Anesthesiology 2000;92:347-54.
  • 10 Mercadante S. Celiac plexus block versus analgesics in pancreatic cancer pain. Pain 1993;52:187-92.
  • 11 Bridenbaugh LD, Moore DC, Campbell DD. Management of upper abdominal cancer pain: Treatment with celiac plexus block with alcohol. JAMA 1964;190:877-80.
  • 12 Kawamata M, Ishitani K, Ishikawa K, Sasaki H, Ota K, Omote K, et al. Comparison between celiac plexus block and morphine treatment on quality of life in patients with pancreatic cancer pain. Pain 1996;64:597-602.
  • 13 Amr YM, Makharita MY. Comparative study between 2 protocols for management of severe pain in patients with unresectable pancreatic cancer: One-year follow-up. Clin J Pain 2013;29:807-13.
  • 14 Soweid AM, Azar C. Endoscopic ultrasound-guided celiac plexus neurolysis. World J Gastrointest Endosc 2010;2:228-31.
  • 15 Seicean A. Celiac plexus neurolysis in pancreatic cancer: The endoscopic ultrasound approach. World J Gastroenterol 2014;20:110-7.
  • 16 Montero Matamala A, Vidal Lopez F, Aguilar Sanchez JL, Donoso Bach L. Percutaneous anterior approach to the coeliac plexus using ultrasound. Br J Anaesth 1989;62:637-40.