Format

Send to

Choose Destination
Gastrointest Endosc. 2011 Dec;74(6):1300-7. doi: 10.1016/j.gie.2011.07.073. Epub 2011 Oct 13.

A prospective, randomized study of EUS-guided celiac plexus neurolysis for pancreatic cancer: one injection or two?

Author information

1
Division of Gastroenterology & Hepatology, Indiana University Medical Center/IU Health, Indianapolis, Indiana, USA. juleblan@iupui.edu

Abstract

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.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00583479.

PMID:
22000795
DOI:
10.1016/j.gie.2011.07.073
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center