Pancreas Pain
Neurolytic celiac plexus block (NCPB) is claimed to be an effective
method of pain control for pancreatic cancer pain. However, the factors
that may influence long-term analgesia, adverse effects, and quality of
life after performing NCPB have never been determined. In a prospective
multicenter study, 22 patients who underwent NCPB were followed until
death. Numerous parameters other than pain and symptom intensity were
evaluated, including age, gender, initial site of cancer, sites of pain,
possible peritoneal involvement, technique, and oncologic
interventions. Indices were calculated to determine the opioid
consumption ratio (EAS) and the trend of opioid escalation (OEI). NCPB
was effective in reducing opioid consumption and gastrointestinal
adverse effects for at least 4 weeks. In the last four weeks prior to
death, there was the typical trend of increasing symptom intensity
common to the terminal cancer population. None of the factors studied
influenced the analgesic effectiveness of NPCB. NPCB, performed by
skilled clinicians, regardless of the technique chosen, is a safe and
useful means that should be considered as an adjuvant to common
analgesic regimens at any stage, as it may allow the reduction of the
visceral component of pancreatic pain that may prevail in certain phases
of the illness. The analgesic and symptomatic effect of NCPB is
presumably advantageous for about four weeks. A possible factor
interfering with long-term outcome includes the capacity of cancer to
involve the celiac axis, which can distort the anatomy and prevent
neurolytic spread, or modify the pain mechanisms. Outcomes are strongly
based on individual variation.
Pancreas Pain
Pancreas Pain
Pancreas Pain
Pancreas Pain
Pancreas Pain
Pancreas Pain
Pancreas Pain
Pancreas Pain
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