Phenol-based endoscopic ultrasound-guided celiac plexus neurolysis for East Asian alcohol-intolerant upper gastrointestinal cancer patients:A pilot study

• Published in: World journal of gastroenterology : WJG 2014-08, Vol.20 (30), p.10512-10517
• Main Authors: Ishiwatari, Hirotoshi, Hayashi, Tsuyoshi, Yoshida, Makoto, Ono, Michihiro, Masuko, Hiroyuki, Sato, Tsutomu, Miyanishi, Koji, Sato, Yasushi, Takimoto, Rishu, Kobune, Masayoshi, Miyamoto, Atsushi, Sonoda, Tomoko, Kato, Junji
• Format: Article
• Language: English
• Subjects: Abdominal Pain - diagnosis; Abdominal Pain - ethnology; Abdominal Pain - etiology; Abdominal Pain - therapy; Aged; Aged, 80 and over; Asian Continental Ancestry Group; blockade; Celiac; Celiac Plexus; Endosonography; Ethanol - administration & dosage; Ethanol - adverse effects; Female; Gastrointestinal Neoplasms - complications; Gastrointestinal Neoplasms - ethnology; Humans; Japan - epidemiology; Male; Middle Aged; Nerve Block - adverse effects; Nerve Block - methods; neurolysis; Pain Management - adverse effects; Pain Management - methods; Pain Measurement; Phenol - administration & dosage; Phenol - adverse effects; Pilot Projects; plexus; Retrospective Studies; Retrospective Study; Time Factors; Treatment Outcome
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v20.i30.10512

AIM:To investigate the effectiveness of phenol for the relief of cancer pain by endoscopic ultrasound-guided celiac plexus neurolysis(EUS-CPN).METHODS:Twenty-two patients referred to our hospital with cancer pain from August 2009 to July 2011for EUS-CPN were enrolled in this study.Phenol was used for 6 patients with alcohol intolerance and ethanol was used for 16 patients without alcohol intolerance.The primary endpoint was the positive response rate(pain score decreased to≤3)on postoperative day 7.Secondary endpoints included the time to onset of pain relief,duration of pain relief,and complication rates.RESULTS:There was no significant difference in the positive response rate on day 7.The rates were 83%and 69%in the phenol and ethanol groups,respectively.Regarding the time to onset of pain relief,in the phenol group,the median pre-treatment pain score was 5,whereas the post-treatment scores decreased to 1.5,1.5,and 1.5 at 2,8,and 24 h,respectively(P<0.05).In the ethanol group,the median pre-treatment pain score was 5.5,whereas the post-treatment scores significantly decreased to 2.5,2.5,and 2.5 at 2,8,and24 h,respectively(P<0.01).There was no significant difference in the duration of pain relief between the phenol and ethanol groups.No significant difference was found in the rate of complications between the 2groups;however,burning pain and inebriation occurred only in the ethanol group.CONCLUSION:Phenol had similar pain-relieving effects to ethanol in EUS-CPN.Comparing the incidences of inebriation and burning pain,phenol may be superior to ethanol in EUS-CPN procedures.