Division of Gastroenterology & Hepatology, Indiana University Medical Center/IU Health, Indianapolis, Indiana, USA.
Gastrointest Endosc. 2011 Dec;74(6):1300-7. doi: 10.1016/j.gie.2011.07.073. Epub 2011 Oct 13.
The technique of alcohol injection during EUS-guided celiac plexus neurolysis (CPN) in patients with pancreatic cancer-related pain has not been standardized.
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.
Single-blinded, prospective, randomized, parallel-group study.
Tertiary-care center.
This study involved patients with pancreatic cancer-related pain.
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.
Time until onset of pain relief, duration of pain relief, complications.
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.
Single-blinded study.
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.
在超声内镜引导下腹腔神经丛阻滞（EUS-CPN）治疗胰腺癌相关疼痛中，酒精注射技术尚未标准化。
比较在超声内镜引导下腹腔神经丛阻滞（EUS-CPN）中给予 1 次和 2 次注射酒精的止痛效果和安全性。次要观察结果为预测反应和生存的特征。
单盲、前瞻性、随机、平行组研究。
三级保健中心。
本研究纳入了胰腺癌相关疼痛患者。
在腹腔干注射 20 mL 0.75%布比卡因和 10 mL 98%酒精，1 或 2 个部位进行 EUS-CPN。参与者通过电话在 24 小时和此后每周进行访谈。
疼痛缓解开始时间、疼痛缓解持续时间、并发症。
共纳入 50 例患者（平均年龄 63 岁；24 例男性），并进行随机分组（1 次注射组 29 例，2 次注射组 21 例）。37 例（74%）患者出现疼痛缓解：1 次注射组 20 例（69%），2 次注射组 17 例（81%）（卡方检验 P =.340）。1 次注射组（范围 1-28 天）和 2 次注射组（范围 1-21 天）的疼痛缓解中位开始时间均为 1 天（Mann-Whitney 检验 P =.943）。1 次注射组和 2 次注射组的疼痛缓解中位持续时间分别为 11 周和 14 周（对数秩检验 P =.612）。总共有 4 例（8%）患者完全缓解，每组 2 例。两组均无长期并发症。
单盲研究。
1 次或 2 次注射在疼痛缓解的开始或持续时间上没有差异。两组在安全性或生存率方面没有差异。
