Value of Adding Dexmedetomidine in Endoscopic Ultrasound-Guided Celiac Plexus Neurolysis for Treatment of Pancreatic Cancer-Associated Pain
| Autor: | Ahmed Abdel Ghafar Saleh, Mohamed Abd El Ghaffar, Ahmed Sultan, Mohamed A Hammouda, Ahmed Shawki |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Endoscopic ultrasound Abdominal pain Sedation Celiac Plexus Neurolysis Celiac Plexus Kaplan-Meier Estimate Endosonography 03 medical and health sciences 0302 clinical medicine Pancreatic cancer medicine Back pain Humans Prospective Studies Dexmedetomidine Pancreas Ultrasonography Interventional Aged Pain Measurement Bupivacaine medicine.diagnostic_test business.industry Gastroenterology Nerve Block Cancer Pain Middle Aged medicine.disease Pancreatic Neoplasms Treatment Outcome Oncology Case-Control Studies 030220 oncology & carcinogenesis Anesthesia Female 030211 gastroenterology & hepatology medicine.symptom business medicine.drug |
| Zdroj: | Journal of Gastrointestinal Cancer. 52:682-689 |
| ISSN: | 1941-6636 1941-6628 |
| Popis: | Abdominal and back pain is present in up to 80% of patients with pancreatic cancer and represents a significant cause of morbidity. Celiac plexus neurolysis (CPN) demonstrated good results in relief of pain of upper abdominal malignancy. Dexmedetomidine is alpha-2 adrenoceptor highly selective agonist approved for procedural sedation use. Fifty patients divided in two groups with locally advanced pancreatic cancer-associated abdominal pain underwent endoscopic ultrasound (EUS)-guided CPN using bupivacaine 0.5% alone with alcohol for the first group and bupivacaine 0.5% plus dexmedetomidine in the second. Patients scored their pain according to the Numeric Rating Scale (NRS-11) before, 2, 4, 6, 8, 12, 16, and 24 week after the procedure. The study has included 50 patient in two groups. There was no significant difference between the two groups as regards medical, laboratory, or tumor characters. The median pain score decreases from 8.32 ± 0.75 before the procedure to 3.75 ± 3.72 24 week after the procedure in group 1 and from 8.08 ± 0.86 before to 1.67 ± 2.3 24 week after the procedure in group 2. However, there was no significant difference between the two groups in the median pain score during the first 4 weeks. There was no statistically significant difference between the two groups as regards the median survival time. The addition of dexmedetomidine to bupivacaine 0.5% in EUS-CPN demonstrated beneficial effects as regards the degree and duration of pain relieve with negligible effect on the patient survival. |
| Databáze: | OpenAIRE |
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