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Comparison between radiofrequency ablation and chemical neurolysis of thoracic splanchnic nerves for the management of abdominal cancer pain, randomized trial
Background Radiofrequency ablation (RFA) of the splanchnic nerves has been reported as a predictable and safe technique for abdominal pain management. We compare between RFA and chemical neurolysis of bilateral thoracic splanchnic nerves in the management of refractory cancer pain. Methods The study...
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| Published in: | European journal of pain 2018-11, Vol.22 (10), p.1782-1790 |
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| Main Authors: | , , , , , , |
| Format: | Article |
| Language: | English |
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| container_end_page | 1790 |
| container_issue | 10 |
| container_start_page | 1782 |
| container_title | European journal of pain |
| container_volume | 22 |
| creator | Amr, S.A. Reyad, R.M. Othman, A.H. Mohamad, M.F. Mostafa, M.M. Alieldin, N.H. Hamed, F.A. |
| description | Background
Radiofrequency ablation (RFA) of the splanchnic nerves has been reported as a predictable and safe technique for abdominal pain management. We compare between RFA and chemical neurolysis of bilateral thoracic splanchnic nerves in the management of refractory cancer pain.
Methods
The study was conducted on 60 patients aged ≥18 years who suffered from abdominal pain (visceral pain, VAS ≥4) due to upper abdominal cancers. Participants were randomized into two groups. Group I (RF): 30 participants received a bilateral splanchnic nerve block at T10 and T11 levels using RFA. Group II (alcohol): 30 participants received a bilateral splanchnic nerve block at T11 using alcohol. Pain relief was assessed using VAS (0–10) and total daily oral opioid consumption (primary outcome).
Results
Significant reductions of VAS and global perceived effect satisfaction scores (GPES) were observed in both groups compared to baseline levels (p |
| doi_str_mv | 10.1002/ejp.1274 |
| format | article |
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Radiofrequency ablation (RFA) of the splanchnic nerves has been reported as a predictable and safe technique for abdominal pain management. We compare between RFA and chemical neurolysis of bilateral thoracic splanchnic nerves in the management of refractory cancer pain.
Methods
The study was conducted on 60 patients aged ≥18 years who suffered from abdominal pain (visceral pain, VAS ≥4) due to upper abdominal cancers. Participants were randomized into two groups. Group I (RF): 30 participants received a bilateral splanchnic nerve block at T10 and T11 levels using RFA. Group II (alcohol): 30 participants received a bilateral splanchnic nerve block at T11 using alcohol. Pain relief was assessed using VAS (0–10) and total daily oral opioid consumption (primary outcome).
Results
Significant reductions of VAS and global perceived effect satisfaction scores (GPES) were observed in both groups compared to baseline levels (p < 0.001); Group I had the largest reduction. MST consumption and QOL scores improved significantly in both groups (p < 0.001). Oral opioid consumption started to reduce at the end of the first post‐interventional week for Group I, 0.00 (0–45 mg), and at the end of the second post‐interventional week for Group II, 20.00 (0–135 mg). No major complications were recorded in either group.
Conclusion
Simultaneous bilateral pain block of splanchnic nerves at the levels of T10 and T11 using RFA is more effective than using alcohol at a single level of T11 in cancer patients presenting with upper abdominal pain. The RFA intervention acted faster, provided longer duration analgesia, worked in a higher proportion of patients and had a better safety profile than the alcohol intervention.
Significance
Radiofrequency ablation of the splanchnic nerves is safe and effective for relieving upper abdominal cancer pain.</description><identifier>ISSN: 1090-3801</identifier><identifier>EISSN: 1532-2149</identifier><identifier>DOI: 10.1002/ejp.1274</identifier><identifier>PMID: 29975804</identifier><language>eng</language><publisher>England</publisher><ispartof>European journal of pain, 2018-11, Vol.22 (10), p.1782-1790</ispartof><rights>2018 European Pain Federation ‐ EFIC</rights><rights>2018 European Pain Federation - EFIC®.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3214-56b8abc6c7554b4309190b1958de06bd44169eeb778a6150bf0bb06c955208a43</citedby><cites>FETCH-LOGICAL-c3214-56b8abc6c7554b4309190b1958de06bd44169eeb778a6150bf0bb06c955208a43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29975804$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Amr, S.A.</creatorcontrib><creatorcontrib>Reyad, R.M.</creatorcontrib><creatorcontrib>Othman, A.H.</creatorcontrib><creatorcontrib>Mohamad, M.F.</creatorcontrib><creatorcontrib>Mostafa, M.M.</creatorcontrib><creatorcontrib>Alieldin, N.H.</creatorcontrib><creatorcontrib>Hamed, F.A.</creatorcontrib><title>Comparison between radiofrequency ablation and chemical neurolysis of thoracic splanchnic nerves for the management of abdominal cancer pain, randomized trial</title><title>European journal of pain</title><addtitle>Eur J Pain</addtitle><description>Background
Radiofrequency ablation (RFA) of the splanchnic nerves has been reported as a predictable and safe technique for abdominal pain management. We compare between RFA and chemical neurolysis of bilateral thoracic splanchnic nerves in the management of refractory cancer pain.
Methods
The study was conducted on 60 patients aged ≥18 years who suffered from abdominal pain (visceral pain, VAS ≥4) due to upper abdominal cancers. Participants were randomized into two groups. Group I (RF): 30 participants received a bilateral splanchnic nerve block at T10 and T11 levels using RFA. Group II (alcohol): 30 participants received a bilateral splanchnic nerve block at T11 using alcohol. Pain relief was assessed using VAS (0–10) and total daily oral opioid consumption (primary outcome).
Results
Significant reductions of VAS and global perceived effect satisfaction scores (GPES) were observed in both groups compared to baseline levels (p < 0.001); Group I had the largest reduction. MST consumption and QOL scores improved significantly in both groups (p < 0.001). Oral opioid consumption started to reduce at the end of the first post‐interventional week for Group I, 0.00 (0–45 mg), and at the end of the second post‐interventional week for Group II, 20.00 (0–135 mg). No major complications were recorded in either group.
Conclusion
Simultaneous bilateral pain block of splanchnic nerves at the levels of T10 and T11 using RFA is more effective than using alcohol at a single level of T11 in cancer patients presenting with upper abdominal pain. The RFA intervention acted faster, provided longer duration analgesia, worked in a higher proportion of patients and had a better safety profile than the alcohol intervention.
Significance
Radiofrequency ablation of the splanchnic nerves is safe and effective for relieving upper abdominal cancer pain.</description><issn>1090-3801</issn><issn>1532-2149</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kcFu1DAQhi0EoqUg8QTIRw6kjBPbiY9oVVpQJXoo52jsTFhXiR3sbKvlYfqseGmBU08eeb75R__8jL0VcCoA6o90s5yKupXP2LFQTV3VQprnpQYDVdOBOGKvcr4BANlC85Id1ca0qgN5zO43cV4w-RwDt7TeEQWecPBxTPRzR8HtOdoJV1_6GAbutjR7hxMPtEtx2mefeRz5uo0JnXc8LxMGtw2lDJRuKfMxptImPmPAHzRTWA8DaIc4-1CEXOEp8QV9-FBWh8P_Lxr4mjxOr9mLEadMbx7fE_b989n15qK6_Hb-ZfPpsnJN8VopbTu0TrtWKWllA0YYsMKobiDQdpBSaENk27ZDLRTYEawF7YxSNXQomxP2_kF3SbHYzms_--xoKmYo7nJfg9ay7bQQ_1GXYs6Jxn5Jfsa07wX0hzT6kkZ_SKOg7x5Vd3am4R_49_wFqB6AOz_R_kmh_uzr1R_B3_8HlpU</recordid><startdate>201811</startdate><enddate>201811</enddate><creator>Amr, S.A.</creator><creator>Reyad, R.M.</creator><creator>Othman, A.H.</creator><creator>Mohamad, M.F.</creator><creator>Mostafa, M.M.</creator><creator>Alieldin, N.H.</creator><creator>Hamed, F.A.</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201811</creationdate><title>Comparison between radiofrequency ablation and chemical neurolysis of thoracic splanchnic nerves for the management of abdominal cancer pain, randomized trial</title><author>Amr, S.A. ; Reyad, R.M. ; Othman, A.H. ; Mohamad, M.F. ; Mostafa, M.M. ; Alieldin, N.H. ; Hamed, F.A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3214-56b8abc6c7554b4309190b1958de06bd44169eeb778a6150bf0bb06c955208a43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Amr, S.A.</creatorcontrib><creatorcontrib>Reyad, R.M.</creatorcontrib><creatorcontrib>Othman, A.H.</creatorcontrib><creatorcontrib>Mohamad, M.F.</creatorcontrib><creatorcontrib>Mostafa, M.M.</creatorcontrib><creatorcontrib>Alieldin, N.H.</creatorcontrib><creatorcontrib>Hamed, F.A.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of pain</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Amr, S.A.</au><au>Reyad, R.M.</au><au>Othman, A.H.</au><au>Mohamad, M.F.</au><au>Mostafa, M.M.</au><au>Alieldin, N.H.</au><au>Hamed, F.A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison between radiofrequency ablation and chemical neurolysis of thoracic splanchnic nerves for the management of abdominal cancer pain, randomized trial</atitle><jtitle>European journal of pain</jtitle><addtitle>Eur J Pain</addtitle><date>2018-11</date><risdate>2018</risdate><volume>22</volume><issue>10</issue><spage>1782</spage><epage>1790</epage><pages>1782-1790</pages><issn>1090-3801</issn><eissn>1532-2149</eissn><abstract>Background
Radiofrequency ablation (RFA) of the splanchnic nerves has been reported as a predictable and safe technique for abdominal pain management. We compare between RFA and chemical neurolysis of bilateral thoracic splanchnic nerves in the management of refractory cancer pain.
Methods
The study was conducted on 60 patients aged ≥18 years who suffered from abdominal pain (visceral pain, VAS ≥4) due to upper abdominal cancers. Participants were randomized into two groups. Group I (RF): 30 participants received a bilateral splanchnic nerve block at T10 and T11 levels using RFA. Group II (alcohol): 30 participants received a bilateral splanchnic nerve block at T11 using alcohol. Pain relief was assessed using VAS (0–10) and total daily oral opioid consumption (primary outcome).
Results
Significant reductions of VAS and global perceived effect satisfaction scores (GPES) were observed in both groups compared to baseline levels (p < 0.001); Group I had the largest reduction. MST consumption and QOL scores improved significantly in both groups (p < 0.001). Oral opioid consumption started to reduce at the end of the first post‐interventional week for Group I, 0.00 (0–45 mg), and at the end of the second post‐interventional week for Group II, 20.00 (0–135 mg). No major complications were recorded in either group.
Conclusion
Simultaneous bilateral pain block of splanchnic nerves at the levels of T10 and T11 using RFA is more effective than using alcohol at a single level of T11 in cancer patients presenting with upper abdominal pain. The RFA intervention acted faster, provided longer duration analgesia, worked in a higher proportion of patients and had a better safety profile than the alcohol intervention.
Significance
Radiofrequency ablation of the splanchnic nerves is safe and effective for relieving upper abdominal cancer pain.</abstract><cop>England</cop><pmid>29975804</pmid><doi>10.1002/ejp.1274</doi><tpages>9</tpages></addata></record> |
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| title | Comparison between radiofrequency ablation and chemical neurolysis of thoracic splanchnic nerves for the management of abdominal cancer pain, randomized trial |
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