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经椎间盘入路至膈脚后间隙的内脏神经溶解阻滞的长期镇痛疗效:一项多中心回顾性研究

Long-Term Analgesic Efficacy of Neurolytic Splanchnic Nerve Block via the Transintervertebral Disc Approach to Retrocrural Space: A Multicenter Retrospective Study.

作者信息

Yanaizumi Ryota, Nagamine Yusuke, Harada Shinsuke, Kuramochi Tomoko, Ota Shuhei, Abe Yoichiro, Nakagawa Masayuki, Kamijima Kenya, Hayashi Maya, Tazawa Toshiharu, Ogawa Kenichi, Goto Takahisa

机构信息

Department of Anesthesiology, Yokohama City University Medical Center, Yokohama, Japan.

Department of Anesthesiology and Critical Care Medicine, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan.

出版信息

Pain Ther. 2023 Jun;12(3):825-840. doi: 10.1007/s40122-023-00506-0. Epub 2023 Apr 13.

Abstract

INTRODUCTION

The celiac plexus block is effective for treating intractable cancer pain and has been the focus of many studies. At our affiliated institution, fluoroscopy-guided splanchnic nerve block with a single needle via the transintervertebral disc approach was the first choice of treatment. The short-term efficacy of this technique has been reported, but the long-term efficacy is not clear. In the present study, we investigated the long-term analgesic efficacy of this technique.

METHODS

This multicenter, retrospective, observational study reviewed the medical records of patients who underwent neurolytic splanchnic nerve block (NSNB) via the transintervertebral disc approach for intractable cancer pain at five tertiary hospitals in Japan from April 2005 to October 2020. The primary outcome was the long-term analgesic efficacy of a one-time NSNB via the transintervertebral disc approach.

RESULTS

In total, 76 patients were included in the analysis. The median lowest numerical rating scale (NRS) score was 1 within 14 days. At 1, 2, 3, and 6 months after the nerve block, the median NRS score was also ≤ 2, while the median equivalent oral morphine dose did not show any clinically noticeable increase at those times.

CONCLUSION

The long-term analgesic efficacy of NSNB via the transintervertebral disc approach in patients with intractable cancer pain has been demonstrated.

摘要

引言

腹腔神经丛阻滞对治疗顽固性癌痛有效,一直是众多研究的焦点。在我们的附属医院,经椎间盘入路单针透视引导下的内脏神经阻滞是首选治疗方法。该技术的短期疗效已有报道,但长期疗效尚不清楚。在本研究中,我们调查了该技术的长期镇痛效果。

方法

这项多中心、回顾性、观察性研究回顾了2005年4月至2020年10月期间在日本五家三级医院接受经椎间盘入路神经破坏性内脏神经阻滞(NSNB)治疗顽固性癌痛患者的病历。主要结局是经椎间盘入路一次性NSNB的长期镇痛效果。

结果

共有76例患者纳入分析。在14天内,最低数字评分量表(NRS)评分中位数为1。在神经阻滞后1、2、3和6个月,NRS评分中位数也≤2,而等效口服吗啡剂量在这些时间未出现任何临床上明显的增加。

结论

已证实经椎间盘入路NSNB对顽固性癌痛患者具有长期镇痛效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4bd2/10199966/4c1ebe071224/40122_2023_506_Fig1_HTML.jpg

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