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《Oncology Progress》 2019-02
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Comparative study on the analgesic effect of CT-guided celiac plexus neurolysis of different approaches in the treatment of advanced pancreatic cancer pain

WANG Qingding;LIU Yadong;DU Juan;Department of Pain Management, Luohe Central Hospital;  
Objective To investigate the analgesic effect of CT-guided celiac plexus neurolysis of different approaches in the treatment of advanced pancreatic cancer pain. Method A total of 40 patients with advanced pancreatic cancer were retrospectively analyzed, who were administered with CT-guided celiac plexus neurolysis with approaches through medial diaphragmatic crura(n=19) or lateral diaphragmatic crura(n=21), of which the preoperative and postoperative visual analogue scale(VAS) of pain, the levels of prostaglandin E2(PGE2) and calcitonin gene-related peptide(CGRP)were compared between the two groups. Result The preoperative VAS score were similar in both groups(P0.05). In5 d, 15 d, and 30 d after surgery, the VAS score of the two groups decreased significantly compared with that before surgery, and it was lower in medial diaphragmatic crura group than in lateral diaphragmatic crura group, with statistically significant difference observed(P0.05). The level of PGE2 and CGRP were also comparable in the two groups before surgery(P0.05). In 5 d, 15 d, and 30 d after surgery, patients in both groups were with reduced level of PGE2 and CGRP compared with that before surgery, and those in medial diaphragmatic crura group had significantly lower level of PGE2 and CGRP than those in lateral diaphragmatic crura group(P0.05). The incidence rate of complications in medial diaphragmatic crura group and lateral diaphragmatic crura group was 28.57% and 26.32%, respectively, and there was no significant differences observed(P0.05). Conclusion Different approach of CT-guided celiac plexus neurolysis through medial diaphragmatic crura or lateral diaphragmatic crura can effectively control the pain of advanced pancreatic cancer,and the medial diaphragmatic crura approach is superior in the clinical management.
【CateGory Index】: R735.9
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