Polati E, Finco G, Gottin L, Bassi C, Pederzoli P, Ischia S
Institute of Anaesthesiology and Intensive Care, University of Verona, Italy.
Br J Surg. 1998 Feb;85(2):199-201. doi: 10.1046/j.1365-2168.1998.00563.x.
In a randomized double-blind study the efficacy of neurolytic coeliac plexus block (NCPB) was compared with pharmacological therapy in the treatment of pain from pancreatic cancer.
Twenty-four patients were divided into two groups: 12 patients underwent NCPB (group 1) and 12 were treated with pharmacological therapy (group 2). Immediate and long-term efficacy, mean analgesic consumption, mortality and morbidity were evaluated at follow-up. Statistical analysis was performed with the unpaired t test, Mann-Whitney U test and Fisher's exact test.
Immediately after the block, patients in group 1 reported significant pain relief compared with those in group 2 (P < 0.05), but long-term results did not differ between the groups. Mean analgesic consumption was lower in group 1. There were no deaths. Complications related to NCPB were transient diarrhoea and hypotension (P not significant between groups). Drug-related adverse effects were constipation (five of 12 patients in group 1 versus 12 of 12 in group 2), nausea and/or vomiting (four of 12 patients in group 1 versus 12 of 12 in group 2) (P < 0.05), one gastric ulcer and one gluteal abscess in group 2.
NCPB was associated with a reduction in analgesic drug administration and drug-related adverse effects, representing an effective tool in the treatment of pancreatic cancer pain.
在一项随机双盲研究中，比较了腹腔神经丛阻滞（NCPB）与药物治疗在胰腺癌疼痛治疗中的疗效。
24例患者分为两组：12例接受NCPB治疗（第1组），12例接受药物治疗（第2组）。随访时评估即刻和长期疗效、平均镇痛药消耗量、死亡率和发病率。采用非配对t检验、曼-惠特尼U检验和费舍尔精确检验进行统计学分析。
阻滞术后即刻，第1组患者的疼痛缓解程度明显高于第2组（P<0.05），但两组的长期结果无差异。第1组的平均镇痛药消耗量较低。无死亡病例。与NCPB相关的并发症为短暂性腹泻和低血压（两组间P无显著性差异）。与药物相关的不良反应为便秘（第1组12例患者中有5例，第2组12例患者中有12例）、恶心和/或呕吐（第1组12例患者中有4例，第2组12例患者中有12例）（P<0.05），第2组有1例胃溃疡和1例臀肌脓肿。
NCPB与镇痛药给药量减少及药物相关不良反应减少相关，是治疗胰腺癌疼痛的有效手段。
