A prospective, randomized study of EUS-guided celiac plexus neurolysis for pancreatic cancer: one injection or two? - 02/12/11
Reprint requests: Julia K. LeBlanc, MD, MPH, Associate Professor of Medicine, 550 N. University Blvd, UH 4100, Indianapolis, IN 46202Résumé |
Background |
The technique of alcohol injection during EUS-guided celiac plexus neurolysis (CPN) in patients with pancreatic cancer–related pain has not been standardized.
Objective |
To compare pain relief and safety of alcohol given as 1 versus 2 injections during EUS-guided CPN (EUS-CPN). Secondary outcomes examined were characteristics that predict response and survival.
Design |
Single-blinded, prospective, randomized, parallel-group study.
Setting |
Tertiary-care center.
Patients |
This study involved patients with pancreatic cancer–related pain.
Intervention |
EUS-CPN done by injecting 20 mL of 0.75% bupivacaine and 10 mL 98% alcohol into 1 or 2 sites at the celiac trunk. Participants were interviewed by telephone at 24 hours and weekly thereafter.
Main Outcome Measurements |
Time until onset of pain relief, duration of pain relief, complications.
Results |
Fifty patients (mean age 63 years; 24 men) were enrolled and randomized (29 in 1-injection, 21 in 2-injections groups). Pain relief was observed in 37 (74%) patients: 20 (69%) in the 1-injection group and 17 (81%) in the 2-injection group (chi-square P = .340). Median onset of pain relief was 1 day for both 1-injection (range 1-28 days) and 2-injection (range 1-21 days) groups (Mann-Whitney P = .943). Median duration of pain relief in the 1-injection and 2-injection groups was 11 weeks and 14 weeks, respectively (log-rank P = .612). Complete pain relief was observed in 4 (8%) patients total, 2 in each group. There were no long-term complications.
Limitations |
Single-blinded study.
Conclusion |
There were no differences in onset or duration of pain relief when either 1 or 2 injections were used. There was no difference in safety or survival between the 2 groups. (Clinical trial registration number: NCT00583479.)
Le texte complet de cet article est disponible en PDF.Abbreviation : CPN, EUS-CPN
Plan
| DISCLOSURE: C. Johnson is a stockholder in Eli Lilly & Co. No other financial relationships relevant to this publication were disclosed. |
|
| If you would like to chat with an author of this article, you may contact Dr LeBlanc at juleblan@iupui.edu. |
Vol 74 - N° 6
P. 1300-1307 - décembre 2011 Retour au numéro
Article précédent
- Extracorporeal shock wave lithotripsy with a transportable mini-lithotripter and subsequent endoscopic treatment improves clinical outcome in obstructive calcific chronic pancreatitis
- Vladan Milovic, Till Wehrmann, Christoph F. Dietrich, Adam A. Bailey, Wolfgang F. Caspary, Barbara Braden
- Single-operator cholangioscopy-guided laser lithotripsy in patients with difficult biliary and pancreatic ductal stones (with videos)
- Amit Maydeo, Boon Eu Andrew Kwek, Suryaprakash Bhandari, Mukta Bapat, Vinay Dhir
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?