Department of Pain Management, Xuanwu Hospital of Capital Medical University, Beijing, China.
Pain Med. 2012 Apr;13(4):518-21. doi: 10.1111/j.1526-4637.2012.01332.x. Epub 2012 Feb 23.
The objective of this study was to assess outcomes and safety of consecutive neurolytic celiac plexus block (NCPB) technique.
Retrospective clinical data analysis.
The study was conducted in three pain departments and academic medical center.
The subject of this study was 12 patients with terminal visceral (mostly pancreatic) cancer who failed conservative measures.
Twelve celiac plexus alcohol neurolytic procedures were performed for pain control after a positive diagnostic block.
Twelve patients with terminal visceral (mostly pancreatic) cancer who failed conservative measures were managed by consecutive NCPB guided by computed tomography at the pain department of Beijing Xuanwu Hospital between January 2005 and June 2010. The present study evaluated the efficacy of consecutive NCPB technique with regard to pain relief, as well as its adverse effects and complications.
The efficacy of consecutive NCPB technique with regard to pain relief was observed by a marked decrease in the visual analog score and in opioid consumption, with preprocedural mean values dropping from (8.7±1.0) and (155±56)mg/day of morphine to (1.8±1.1) and (0)mg/day at the first postprocedural visit, respectively. These results persisted during the 6-month follow-up period or until death. Minor adverse effects (moderate diarrhea and mild hypotension) were frequent (N=3, and N=4, respectively), and severe complications occurred in one patient with a transient paraparesis (N=1). No procedure-related mortality was observed.
The consecutive NCPB technique can provide analgesia and the alleviation of the secondary undesirable effects of analgesic drugs resulting from the decrease of morphine consumption in patients with upper abdominal malignancies. In the subject group, the reliability of its analgesic effect is high, with lower rate of severe complications.
本研究旨在评估连续腹腔神经丛阻滞（NCPB）技术的疗效和安全性。
回顾性临床数据分析。
本研究在三个疼痛科和学术医学中心进行。
本研究的对象是 12 例因保守治疗失败而患有终末期内脏（主要是胰腺）癌的患者。
12 例终末期内脏（主要是胰腺）癌患者在疼痛科接受 CT 引导的连续 NCPB 治疗，以控制疼痛。
2005 年 1 月至 2010 年 6 月，12 例因保守治疗失败而患有终末期内脏（主要是胰腺）癌的患者在北京宣武医院疼痛科接受连续 NCPB 治疗。本研究评估了连续 NCPB 技术在缓解疼痛方面的疗效，以及其不良反应和并发症。
连续 NCPB 技术在缓解疼痛方面的疗效显著，表现为视觉模拟评分和阿片类药物用量明显减少，术前平均数值分别从（8.7±1.0）和（155±56）mg/天降至术后首次就诊时的（1.8±1.1）和（0）mg/天。这些结果在 6 个月的随访期或直至死亡时持续存在。轻微不良反应（中度腹泻和轻度低血压）较为常见（分别为 N=3 和 N=4），1 例患者出现短暂性截瘫（N=1）的严重并发症。无与操作相关的死亡。
连续 NCPB 技术可在减少吗啡用量的情况下，为上腹部恶性肿瘤患者提供镇痛和减轻阿片类药物的继发性不良反应。在本研究对象中，其镇痛效果可靠，严重并发症发生率较低。
